Organization Active NPI

Professional Chiropractic & Rehabilition Center P.C.

  • Chiropractor
  • Virginia Beach, VA
National Provider Identifier
1023181302
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104556069 Issued in VA
Legal business name
PROFESSIONAL CHIROPRACTIC & REHABILITION CENTER P.C.
Practice address
810 Kempsville Rd Ste 1
Virginia Beach, VA 23464-2723
Phone
(757) 424-2626
Fax
(757) 366-0129
NPI assigned
Nov 16, 2006
Last updated
May 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Authorized official

Name
Dr. Speros Tryphonas, B.SC., D.CNPI 1851484331
Title
Doctor President
Phone
(757) 424-2626

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104556069 VA Primary

Addresses

Primary practice location

810 Kempsville Rd Ste 1
Virginia Beach, VA 23464-2723

Mailing address

810 Kempsville Rd Ste 1
Virginia Beach, VA 23464-2723
Phone (757) 424-2626

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060202000957 VA Part B Supplier - Clinic/Group Practice 2062426661 Receives reassigned benefits from 2 practitioners
Practice locations: Virginia Beach, VA

National Provider Directory

National Provider Directory

Locations

5350 Kempsriver Dr
Ste 110
Virginia Beach, VA 23464
Phone (757) 424-2626

5386 Kempsriver Dr
Ste 102
Virginia Beach, VA 23464
Phone (757) 424-2626

810 Kempsville Rd
Ste 1
Virginia Beach, VA 23464
Phone (757) 313-5420

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716422400000",
    "number": "1023181302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 KEMPSVILLE RD STE 1",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234642723",
            "telephone_number": "757-424-2626",
            "fax_number": "757-366-0129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 KEMPSVILLE RD STE 1",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234642723",
            "telephone_number": "757-424-2626",
            "fax_number": "757-366-0129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL CHIROPRACTIC & REHABILITION CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A",
        "authorized_official_last_name": "TRYPHONAS",
        "authorized_official_first_name": "SPEROS",
        "authorized_official_title_or_position": "DOCTOR    PRESIDENT",
        "authorized_official_telephone_number": "757-424-2626",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "B.SC., D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.