Peace in Peace Out Program

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

Legal business name

PEACE IN PEACE OUT PROGRAM

Practice address

17217 Hedgerow Park Rd
Charlotte, NC 28277-6662

Phone

(704) 668-8600

NPI assigned

Mar 20, 2013

Last updated

Mar 20, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Aly Faber, E-RYT, CYT, IYAT

Title

Owner/Member

Phone

(704) 668-8600

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1363737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363737600000",
    "number": "1922340660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17217 HEDGEROW PARK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282776662",
            "telephone_number": "704-668-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17217 HEDGEROW PARK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282776662",
            "telephone_number": "704-668-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE IN PEACE OUT PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-20",
        "last_updated": "2013-03-20",
        "status": "A",
        "authorized_official_last_name": "FABER",
        "authorized_official_first_name": "ALY",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "704-668-8600",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "E-RYT, CYT, IYAT"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rehabilitation Chiropractor in Charlotte, NC
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2013; 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.