Active NPI
Benjamin Walter Erese II, D.C.
- Chiropractor
- Salisbury, NC
National Provider Identifier
1972533693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2655
- Practice address
- 1122 N Main St
Salisbury, NC 28144-3614 - Phone
- (704) 636-0741
- Fax
- (704) 636-0793
- NPI assigned
- Jul 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2655 | NC | Primary |
Addresses
Primary practice location
1122 N Main St
Salisbury, NC 28144-3614
Mailing address
1122 N Main St
Salisbury, NC 28144-3614
Phone (704) 636-0741
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89085CE | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2655 | NC | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204502400000",
"number": "1972533693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1122 N MAIN ST",
"city": "SALISBURY",
"state": "NC",
"postal_code": "281443614",
"telephone_number": "704-636-0741",
"fax_number": "704-636-0793"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1122 N MAIN ST",
"city": "SALISBURY",
"state": "NC",
"postal_code": "281443614",
"telephone_number": "704-636-0741",
"fax_number": "704-636-0793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERESE",
"first_name": "BENJAMIN",
"middle_name": "WALTER",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-05",
"last_updated": "2008-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NC",
"license": "2655",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89085CE",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salisbury, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.