Individual provider Active NPI

Erica Ms Statman, D.C.DI.C.C.P.

  • Chiropractor
  • Fairfax, VA
National Provider Identifier
1104970938
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104001952 Issued in VA
Practice address
10807 Main St
Suite 800
Fairfax, VA 22030-4730
Phone
(703) 383-1630
Fax
(703) 383-1631
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104001952 VA Primary

Addresses

Primary practice location

10807 Main St
Suite 800
Fairfax, VA 22030-4730

Mailing address

10807 Main St
Suite 800
Fairfax, VA 22030-4730
Phone (703) 383-1630

Other names 1

  • Erica Ms Schachner Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100616000119 DC Practitioner - Chiropractic 9638209778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10807 Main St
Fairfax, VA 22030-4730
Phone (703) 383-4630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104001952VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Chiropractic PC Chiropractor CurrentSince Jan 20, 1999 Accepting new patients
Fairfax Acupuncture Center, Inc. Past Accepting new patients

Locations

10807 Main St
Ste 800
Fairfax, VA 22030
Phone (703) 383-1630

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1104970938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10807 MAIN ST",
            "address_2": "SUITE 800",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220304730",
            "telephone_number": "703-383-1630",
            "fax_number": "703-383-1631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10807 MAIN ST",
            "address_2": "SUITE 800",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220304730",
            "telephone_number": "703-383-1630",
            "fax_number": "703-383-1631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATMAN",
        "first_name": "ERICA",
        "middle_name": "MS",
        "name_prefix": "Dr.",
        "credential": "D.C.DI.C.C.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104001952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERICA",
            "last_name": "SCHACHNER",
            "middle_name": "MS",
            "credential": "D.C.DI.C.C.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.