Active NPI
Carlyn Grace Van Blaricum, DC
- Chiropractor
- Williamsburg, VA
National Provider Identifier
1184252520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 0104-557635
- Practice address
- 219 McLaws Cir
Williamsburg, VA 23185-5649 - Phone
- (757) 259-1122
- NPI assigned
- Mar 31, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 0104-557635 | VA | Primary |
Addresses
Primary practice location
219 McLaws Cir
Williamsburg, VA 23185-5649
Mailing address
902 Conway Dr Apt 204
Williamsburg, VA 23185-3838
Phone (913) 568-1556
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0104-557635 | VA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585612800000",
"number": "1184252520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "902 CONWAY DR APT 204",
"city": "WILLIAMSBURG",
"state": "VA",
"postal_code": "231853838",
"telephone_number": "913-568-1556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "219 MCLAWS CIR",
"city": "WILLIAMSBURG",
"state": "VA",
"postal_code": "231855649",
"telephone_number": "757-259-1122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN BLARICUM",
"first_name": "CARLYN",
"middle_name": "GRACE",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-31",
"last_updated": "2020-03-31",
"certification_date": "2020-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "VA",
"license": "0104-557635",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Williamsburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.