1. Home
  2. Directory
  3. North Carolina
  4. Raleigh
  5. Chiropractor
  6. NPI Profile

HEALTHSOURCE OF LAKE BOONE TRAIL, PLLC
NPI 1255616611
Chiropractor in Raleigh, NC

Active since October 18, 2011
4025 LAKE BOONE TRL, SUITE 120, RALEIGH, NC 27607(919) 785-9191(919) 785-9193 Get Directions Write a Review

NPPES record last updated: November 10, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Healthsource Of Lake Boone Trail, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HEALTHSOURCE OF LAKE BOONE TRAIL, PLLC (NPI 1255616611) is a healthcare organization registered as a chiropractor in Raleigh, North Carolina and active in the NPI registry since October 2011. The organization lists Lisa C Evans, Billing Manager, as its authorized official.

NPPES Registry Identity

NPI1255616611
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NameHEALTHSOURCE OF LAKE BOONE TRAIL, PLLC
Location Address4025 LAKE BOONE TRL, SUITE 120Raleigh, NC 27607-2986
Mailing Address4025 Lake Boone Trail, Suite 120Raleigh, NC 27607-2986 · (910) 431-4330
Phone(919) 785-9191
Fax(919) 785-9193
Organization SubpartNo
Authorized OfficialLisa C EvansBilling Manager · (919) 585-7365
Enumeration DateOctober 18, 2011
Last NPPES UpdateNovember 10, 2011
✔ NPI 1255616611 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in NC · 3364
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
4025 LAKE BOONE TRL, Raleigh, NC 27607
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEALTHSOURCE OF RALEIGH NORTHWEST
Chiropractor
4025 LAKE BOONE TRL, SUITE 120
RALEIGH, NC 27607
Wake County (919) 785-9191

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Healthsource Of Lake Boone Trail, PLLC's NPI number?

The NPI number for Healthsource Of Lake Boone Trail, PLLC is 1255616611. It was assigned to this organization in the NPPES registry on October 18, 2011.

Where is Healthsource Of Lake Boone Trail, PLLC located?

Healthsource Of Lake Boone Trail, PLLC is located at 4025 Lake Boone Trl Suite 120, Raleigh, NC 27607. The listed phone number is (919) 785-9191.

What is Healthsource Of Lake Boone Trail, PLLC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

When was this NPI record last updated?

The NPPES record for Healthsource Of Lake Boone Trail, PLLC was last updated on November 10, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.