Individual provider Active NPI

Matthew T Liles, DC

  • Chiropractor
  • Wilson, NC
National Provider Identifier
1972256147
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
NC5219 Issued in NC
Practice address
2519 Airport Blvd NW Ste F
Wilson, NC 27896-9603
Phone
(252) 201-8990
NPI assigned
Jan 28, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NC5219 NC Primary

Addresses

Primary practice location

2519 Airport Blvd NW Ste F
Wilson, NC 27896-9603

Mailing address

2519 Airport Blvd NW Ste F
Wilson, NC 27896-9603

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241104003901 NC Practitioner - Chiropractic 6204369879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Liles Family Chiropractic PLLCGroup PAC ID 5395278964, 2 clinicians

Practice addresses (Care Compare)

2519 Airport Blvd NW
Wilson, NC 27896-9603
Phone (252) 201-8990

2519 Airport Blvd NW B
Wilson, NC 27896-9603

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5219NCMDCounselor
NC5219NCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Liles Family Chiropractic PLLC Chiropractor CurrentSince Aug 12, 2024 Accepting new patients

Locations

2519 Airport Blvd NW
Ste F
Wilson, NC 27896
Phone (252) 201-8990

2519 Airport Blvd NW
Ste B
Wilson, NC 27896
Phone (252) 201-8990

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": "1643328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1972256147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2519 AIRPORT BLVD NW STE F",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278969603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2519 AIRPORT BLVD NW STE F",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278969603",
            "telephone_number": "252-201-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILES",
        "first_name": "MATTHEW",
        "middle_name": "T",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-28",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "NC5219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; 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.