Organization Active NPI

Nackley Chiropractic, PA

  • Chiropractor
  • Goldsboro, NC
National Provider Identifier
1891371712
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
NACKLEY CHIROPRACTIC, PA
Practice address
1100 Parkway Dr Ste B
Goldsboro, NC 27534-3477
Phone
(919) 751-1155
Fax
(919) 751-1151
NPI assigned
Mar 22, 2021
Last updated
Mar 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jason Joseph Nackley, DCNPI 1235341298
Title
Owner
Phone
(919) 751-1155

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary
Acupuncturist 171100000X NU

Addresses

Primary practice location

1100 Parkway Dr Ste B
Goldsboro, NC 27534-3477

Mailing address

1100 Parkway Dr Ste B
Goldsboro, NC 27534-3477
Phone (919) 751-1155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210601000515 NC Part B Supplier - Clinic/Group Practice 6901205608 Receives reassigned benefits from 2 practitioners
Practice locations: Goldsboro, NC

National Provider Directory

National Provider Directory

Locations

1100 Parkway Dr
Ste B
Goldsboro, NC 27534
Phone (919) 751-1155

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616371200000",
    "number": "1891371712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 PARKWAY DR STE B",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275343477",
            "telephone_number": "919-751-1155",
            "fax_number": "919-751-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 PARKWAY DR STE B",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275343477",
            "telephone_number": "919-751-1155",
            "fax_number": "919-751-1151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NACKLEY CHIROPRACTIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-22",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A",
        "authorized_official_last_name": "NACKLEY",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-751-1155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.