Organization Active NPI

Longevity Partner LLC

  • Chiropractor
  • Richmond, VA
National Provider Identifier
1104708601
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
LONGEVITY PARTNER LLC
Practice address
4915 Radford Ave Ste 204
Richmond, VA 23230-3546
Phone
(804) 690-9355
NPI assigned
Jul 24, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Authorized official

Name
William Usher RoodmanNPI 1164590709
Title
Authorized Official
Phone
(804) 690-9355

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

4915 Radford Ave Ste 204
Richmond, VA 23230-3546

Mailing address

7102 W Franklin St
Richmond, VA 23226-3640

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251002000987 VA Part B Supplier - Clinic/Group Practice 2668978248 Receives reassigned benefits from 1 practitioner
Practice locations: Richmond, VA

National Provider Directory

National Provider Directory

Locations

4915 Radford Ave
Ste 204
Richmond, VA 23230
Phone (804) 690-9355

Practitioners & affiliated clinicians

Practitioners 1

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": "1753315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753315200000",
    "number": "1104708601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7102 W FRANKLIN ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232263640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 RADFORD AVE STE 204",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232303546",
            "telephone_number": "804-690-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGEVITY PARTNER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-24",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A",
        "authorized_official_last_name": "ROODMAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "USHER",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "804-690-9355"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; 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.