Organization Active NPI

McDonnel LLC

Doing business as Caroline Chiropractic

  • Chiropractor
  • Ruther Glen, VA
National Provider Identifier
1053640730
Registry record updated Dec 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104556359 Issued in VA
Legal business name
MCDONNEL LLC
Doing business as
Caroline Chiropractic
Practice address
17470 Center Dr
Suite 4C
Ruther Glen, VA 22546-2881
Phone
(804) 448-0887
Fax
(804) 448-0887
NPI assigned
Dec 9, 2009
Last updated
Dec 9, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2009

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

Authorized official

Name
Ryan A. McDonnel, D.C.NPI 1427065002
Title
Owner
Phone
(804) 448-0887

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 0104556359 VA Primary

Addresses

Primary practice location

17470 Center Dr
Suite 4C
Ruther Glen, VA 22546-2881

Mailing address

17470 Center Dr
Suite 4C
Ruther Glen, VA 22546-2881
Phone (804) 448-0887

Other names 1

  • Caroline Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100203000492 VA Part B Supplier - Clinic/Group Practice 3476696188 Receives reassigned benefits from 1 practitioner
Practice locations: Ruther Glen, VA

National Provider Directory

National Provider Directory

Locations

17470 Center Dr
Ruther Glen, VA 22546

17470 Center Dr
Ste 4C
Ruther Glen, VA 22546
Phone (804) 448-0887

Practitioners & affiliated clinicians

Practitioners 2

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": "1260316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260316800000",
    "number": "1053640730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17470 CENTER DR",
            "address_2": "SUITE 4C",
            "city": "RUTHER GLEN",
            "state": "VA",
            "postal_code": "225462881",
            "telephone_number": "804-448-0887",
            "fax_number": "804-448-0887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17470 CENTER DR",
            "address_2": "SUITE 4C",
            "city": "RUTHER GLEN",
            "state": "VA",
            "postal_code": "225462881",
            "telephone_number": "804-448-0887",
            "fax_number": "804-448-0887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCDONNEL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-09",
        "last_updated": "2009-12-09",
        "status": "A",
        "authorized_official_last_name": "MCDONNEL",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-448-0887",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Caroline Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ruther Glen, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2009; 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.