Mark E. Bryngelson, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

010400199 Issued in VA

Practice address

147 Garrisonville Rd
Stafford, VA 22554-1523

Phone

(540) 720-6000

Fax

(540) 288-1913

NPI assigned

Jul 2, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mark E. Bryngelson, P.C.

  dba Life Chiropractic Clinic of Stafford

  • Chiropractor
  • Stafford, VA
  • NPI 1508133323
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1184653032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 GARRISONVILLE RD",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225541523",
            "telephone_number": "540-720-6000",
            "fax_number": "540-288-1913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 GARRISONVILLE RD",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225541523",
            "telephone_number": "540-720-6000",
            "fax_number": "540-288-1913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYNGELSON",
        "first_name": "MARK",
        "middle_name": "E.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "010400199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "54-1671414",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NPI",
            "identifier": "1508133323",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Stafford, VA
• Providers in Stafford, VA by specialty
• Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.