NPIMap

Organization Active NPI

Nova Pain & Rehab Center, PLLC

  • Sports Physician Chiropractor
  • Chantilly, VA
National Provider Identifier
1124190053
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
Legal business name
NOVA PAIN & REHAB CENTER, PLLC
Practice address
14290 Sullyfield Cir
Suite 100
Chantilly, VA 20151-4000
Phone
(703) 434-9324
Fax
(703) 933-3745
NPI assigned
Nov 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Karla M Heraud
Title
Office Manager
Phone
(703) 535-8887

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NS0005X Primary

Addresses

Primary practice location

14290 Sullyfield Cir
Suite 100
Chantilly, VA 20151-4000

Mailing address

14290 Sullyfield Cir
Suite 100
Chantilly, VA 20151-4000
Phone (703) 434-9324

National Provider Directory

National Provider Directory

Locations

2955 S Glebe Rd
Ste E
Arlington, VA 22206
Phone (703) 535-8887

2955 S Glebe Rd
Arlington, VA 22206
Phone (703) 535-8887

130 W Jefferson St
Falls Church, VA 22046
Phone (240) 222-2377

Practitioners & affiliated clinicians

Practitioners 6

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": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124190053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14290 SULLYFIELD CIR",
            "address_2": "SUITE 100",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201514000",
            "telephone_number": "703-434-9324",
            "fax_number": "703-933-3745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14290 SULLYFIELD CIR",
            "address_2": "SUITE 100",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201514000",
            "telephone_number": "703-434-9324",
            "fax_number": "703-933-3745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA PAIN & REHAB CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HERAUD",
        "authorized_official_first_name": "KARLA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "703-535-8887",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chantilly, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.