Individual provider Active NPI

Shawn Daniel Keegan, DC

  • Chiropractor
  • Ashburn, VA
National Provider Identifier
1083786578
Registry record updated Feb 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104001716 Issued in VA
Practice address
44355 Premier PLZ
Suite 130
Ashburn, VA 20147-5049
Phone
(703) 858-3500
Fax
(703) 858-9984
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104001716 VA Primary

Addresses

Primary practice location

44355 Premier PLZ
Suite 130
Ashburn, VA 20147-5049

Mailing address

44355 Premier PLZ
Suite 130
Ashburn, VA 20147-5049
Phone (703) 858-3500

Other identifiers 2

IdentifierTypeStateIssuer
453947OtherVAANTHEM BCBS
541921903OtherVAPRIVATE INSURERS TAX ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090121000734 VA Practitioner - Chiropractic 5092879940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

44355 Premier PLZ
Ashburn, VA 20147-5049

44355 Premier PLZ
Suite 130
Ashburn, VA 20147-5050
Phone (703) 858-3500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104001716VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Shawn D Keegan P.C. Chiropractor CurrentSince Dec 26, 2008 Accepting new patients
Clinical Diagnostic Laboratories, LLC PastSince Jan 15, 2023 Accepting new patients

Locations

44335 Premier Plz
Ste 240
Ashburn, VA 20147
Phone (703) 858-3500

44355 Premier Plz
Ste 130
Ashburn, VA 20147
Phone (703) 858-3500

Organizations & group practices 2

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391472000000",
    "number": "1083786578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44355 PREMIER PLZ",
            "address_2": "SUITE 130",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201475049",
            "telephone_number": "703-858-3500",
            "fax_number": "703-858-9984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44355 PREMIER PLZ",
            "address_2": "SUITE 130",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201475049",
            "telephone_number": "703-858-3500",
            "fax_number": "703-858-9984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEGAN",
        "first_name": "SHAWN",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2014-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104001716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "453947",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE INSURERS TAX ID",
            "identifier": "541921903",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashburn, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; 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.