Individual provider Active NPI

Rodriquez Johnson

  • Chiropractor
  • Staunton, VA
National Provider Identifier
1013610625
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104557903 Issued in VA
Practice address
100 Mactanly PL Ste E
Staunton, VA 24401-2383
Phone
(540) 213-3904
NPI assigned
Mar 23, 2023
Last updated
Mar 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104557903 VA Primary

Addresses

Primary practice location

100 Mactanly PL Ste E
Staunton, VA 24401-2383

Mailing address

100 Mactanly PL Ste E
Staunton, VA 24401-2383
Phone (540) 213-3904

Other practice location 1

2556 Jefferson Hwy Ste 104
Waynesboro, VA 22980-6555
Phone (540) 213-3904

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251008003253 DC Practitioner - Chiropractic 3971968744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palmercare Chiropractic Alexandria LLCGroup PAC ID 3274973920, 2 clinicians

Practice addresses (Care Compare)

7770 Richmond Hwy
Suite D
Alexandria, VA 22306-2859
Phone (703) 360-1011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Palmercare Chiropractic Alexandria LLC Chiropractor CurrentSince Sep 14, 2025 Accepting new patients
Alexandria Back & Neck Center Chiropractor PastSince Sep 14, 2025 Accepting new patients
Augusta Health Care for Women, PLC PastSince Mar 26, 2023 Accepting new patients

Locations

7770 Richmond Hwy
Ste D
Alexandria, VA 22306
Phone (703) 360-1011

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1013610625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MACTANLY PL STE E",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244012383",
            "telephone_number": "540-213-3904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MACTANLY PL STE E",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244012383",
            "telephone_number": "540-213-3904"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2556 Jefferson Hwy Ste 104",
            "address_purpose": "LOCATION",
            "city": "Waynesboro",
            "state": "VA",
            "postal_code": "229806555",
            "country_code": "US",
            "telephone_number": "540-213-3904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RODRIQUEZ",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-23",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104557903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staunton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.