Organization Active NPI

Shandon J. Thompson, D.C., P.C.

  • Sports Physician Chiropractor
  • Ashburn, VA
National Provider Identifier
1104082064
Registry record updated Aug 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
0104001181 Issued in VA
Legal business name
SHANDON J. THOMPSON, D.C., P.C.
Doing business as
Loudoun Spine & Sports Group
Practice address
44121 Harry Byrd Hwy
#120
Ashburn, VA 20147-5667
Phone
(703) 777-1234
Fax
(703) 777-8277
NPI assigned
Jul 31, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2010

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

Authorized official

Name
Shandon J Thompson, D.C.NPI 1225112857
Title
President
Phone
(703) 777-1234

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
Sports Physician ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NS0005X 0104001181 VA Primary

Addresses

Primary practice location

44121 Harry Byrd Hwy
#120
Ashburn, VA 20147-5667

Mailing address

44121 Harry Byrd Hwy
#120
Ashburn, VA 20147-5667
Phone (703) 777-1234

Other names 1

  • Loudoun Spine & Sports Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040303000613 VA Part B Supplier - Clinic/Group Practice 2466349402 Receives reassigned benefits from 1 practitioner
Practice locations: Ashburn, VA

National Provider Directory

National Provider Directory

Locations

21 Fort Evans Rd NE
Leesburg, VA 20176
Phone (703) 777-1234

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282003200000",
    "number": "1104082064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44121 HARRY BYRD HWY",
            "address_2": "#120",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201475667",
            "telephone_number": "703-777-1234",
            "fax_number": "571-918-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44121 HARRY BYRD HWY",
            "address_2": "#120",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201475667",
            "telephone_number": "703-777-1234",
            "fax_number": "703-777-8277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANDON J. THOMPSON, D.C., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-31",
        "last_updated": "2010-08-17",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "SHANDON",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-777-1234",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "VA",
            "license": "0104001181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Loudoun Spine & Sports Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 17, 2010; 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.