Individual provider Active NPI

Thomas M Brown, DC

  • Chiropractor
  • Charlotte, NC
National Provider Identifier
1912907189
Registry record updated Apr 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
872 Issued in NC
Practice address
4016 Triangle Dr
Charlotte, NC 28208-2828
Phone
(704) 392-1338
Fax
(704) 392-8156
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 872 NC Primary

Addresses

Primary practice location

4016 Triangle Dr
Charlotte, NC 28208-2828

Mailing address

4016 Triangle Dr
Charlotte, NC 28208-2828
Phone (704) 392-1338

Other identifiers 1

IdentifierTypeStateIssuer
8908277MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1519NCMDOptometrist
872NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Keith Wellness & Rehabilitation Center, P.a. Chiropractor PastSince Jun 1, 2011 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303862400000",
    "number": "1912907189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4016 TRIANGLE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282082828",
            "telephone_number": "704-392-1338",
            "fax_number": "704-392-8156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4016 TRIANGLE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282082828",
            "telephone_number": "704-392-1338",
            "fax_number": "704-392-8156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "THOMAS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2011-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8908277",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.