Organization Active NPI

Blue Ridge Chiropractic Care PLLC

  • Chiropractor
  • North Wilkesboro, NC
National Provider Identifier
1932904042
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BLUE RIDGE CHIROPRACTIC CARE PLLC
Practice address
718A Main St
North Wilkesboro, NC 28659-4212
Phone
(336) 262-6179
NPI assigned
Feb 14, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Authorized official

Name
Dr. Mark J Glanzer, DCNPI 1306840731
Title
Owner
Phone
(336) 667-2225

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

718A Main St
North Wilkesboro, NC 28659-4212

Mailing address

718A Main St
North Wilkesboro, NC 28659-4212
Phone (336) 262-6179

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250926003064 NC Part B Supplier - Clinic/Group Practice 7214432483 Receives reassigned benefits from 1 practitioner
Practice locations: North Wilkesboro, NC

National Provider Directory

National Provider Directory

Locations

718 Main St
#A
North Wilkesboro, NC 28659
Phone (336) 667-2225

718A Main St
North Wilkesboro, NC 28659
Phone (336) 262-6179

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1739491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739491200000",
    "number": "1932904042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718A MAIN ST",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286594212",
            "telephone_number": "336-262-6179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718A MAIN ST",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286594212",
            "telephone_number": "336-262-6179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE CHIROPRACTIC CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-14",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A",
        "authorized_official_last_name": "GLANZER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-667-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Wilkesboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; 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.