NPIMap

Organization Active NPI

Integrative Chiropractic and Natural Medicine

  • Chiropractor
  • Indian Trail, NC
National Provider Identifier
1942560818
Registry record updated May 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
INTEGRATIVE CHIROPRACTIC AND NATURAL MEDICINE
Practice address
6580 Old Monroe Rd Ste a
Indian Trail, NC 28079-5362
Phone
(704) 225-8686
Fax
(704) 225-9988
NPI assigned
May 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2012

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

Authorized official

Name
Dr. Jennifer Robin Degaray, DCNPI 1295930238
Title
Provider/Owner
Phone
(704) 225-8686

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: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

6580 Old Monroe Rd Ste a
Indian Trail, NC 28079-5362

Mailing address

6580 Old Monroe Rd Ste a
Indian Trail, NC 28079-5362
Phone (704) 225-8686

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120809000030 NC Part B Supplier - Clinic/Group Practice 6204082126 Receives reassigned benefits from 6 practitioners
Practice locations: Indian Trail, NC

National Provider Directory

National Provider Directory

Locations

6580 Old Monroe Rd
Ste A
Indian Trail, NC 28079
Phone (704) 225-8686

Practitioners & affiliated clinicians

Practitioners 6

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": "1337817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337817600000",
    "number": "1942560818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6580 OLD MONROE RD STE A",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280795362",
            "telephone_number": "704-225-8686",
            "fax_number": "704-225-9988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6580 OLD MONROE RD STE A",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280795362",
            "telephone_number": "704-225-8686",
            "fax_number": "704-225-9988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE CHIROPRACTIC AND NATURAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-24",
        "last_updated": "2012-05-24",
        "status": "A",
        "authorized_official_last_name": "DEGARAY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "ROBIN",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "704-225-8686",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Trail, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2012; 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.