Individual provider Active NPI

Gregory Joseph Demetrious, DC

  • Chiropractor
  • Wilmington, NC
National Provider Identifier
1942217864
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2238 Issued in NC
Practice address
7491 Market St
Wilmington, NC 28411
Phone
(910) 686-5433
Fax
(910) 686-6737
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2238 NC Primary

Addresses

Primary practice location

7491 Market St
Wilmington, NC 28411

Mailing address

PO Box 10863
Wilmington, NC 28404
Phone (910) 686-5433

Other identifiers 1

IdentifierTypeStateIssuer
890827FMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050325000207 NC Practitioner - Chiropractic 6709841430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7649 Market St
Wilmington, NC 28411-9458
Phone (910) 686-5433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2238NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hanson Chiropractic PLLC Chiropractor CurrentSince Dec 1, 2024 Accepting new patients
Healing Hands Chiro-Prak-Tik, PLLC Chiropractor CurrentSince Nov 12, 2012 Accepting new patients
Eastcoast Diagnostics & Sleep Centers, Inc. PastSince Jan 1, 2005 Accepting new patients

Locations

7649 Market St
Wilmington, NC 28411
Phone (910) 686-5433

Organizations & group practices 3

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942217864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10863",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28404",
            "telephone_number": "910-686-5433",
            "fax_number": "910-686-6737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7491 MARKET ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28411",
            "telephone_number": "910-686-5433",
            "fax_number": "910-686-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMETRIOUS",
        "first_name": "GREGORY",
        "middle_name": "JOSEPH",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890827F",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.