Individual provider Active NPI

Christopher R Perron, D.C.

  • Chiropractor
  • Reston, VA
National Provider Identifier
1023025467
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104 555576 Issued in VA
Practice address
11715 Bowman Green Dr
Reston, VA 20190-3507
Phone
(703) 689-2300
Fax
(703) 689-0234
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104 555576 VA Primary

Addresses

Primary practice location

11715 Bowman Green Dr
Reston, VA 20190-3507

Mailing address

12619 Hay Meadow PL
Oak Hill, VA 20171-2231
Phone (703) 390-9140

Other identifiers 2

IdentifierTypeStateIssuer
257135OtherVAANTHEM BCBS PROVIDER #
7715149OtherVAAETNA PPO PROVIDER #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120220000205 DC Practitioner - Chiropractic 0244498426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1996
Medicare assignment
May accept Medicare assignment
Group practices
Bowman and Associates LLCGroup PAC ID 0648645416, 2 clinicians

Practice addresses (Care Compare)

11715 Bowman Green Dr
Lowr
Reston, VA 20190-3568
Phone (703) 689-2300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104 555576VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bowman and Associates LLC Chiropractor CurrentSince Jan 1, 2023 Accepting new patients

Locations

11715 Bowman Green Dr
Lowr
Reston, VA 20190
Phone (703) 689-2300

11715 Bowman Green Dr
Reston, VA 20190
Phone (505) 259-0146

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023025467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12619 HAY MEADOW PL",
            "city": "OAK HILL",
            "state": "VA",
            "postal_code": "201712231",
            "telephone_number": "703-390-9140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11715 BOWMAN GREEN DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903507",
            "telephone_number": "703-689-2300",
            "fax_number": "703-689-0234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRON",
        "first_name": "CHRISTOPHER",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104 555576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS PROVIDER #",
            "identifier": "257135",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO PROVIDER #",
            "identifier": "7715149",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.