Organization Active NPI

Virginia St Chiropractic, PSC

  • Chiropractor
  • Evansville, IN
National Provider Identifier
1205030152
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
VIRGINIA ST CHIROPRACTIC, PSC
Practice address
4847 E Plaza East Blvd
Evansville, IN 47715-2811
Phone
(812) 477-4444
Fax
(812) 477-4561
NPI assigned
Jun 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Authorized official

Name
Amber James, D.C.NPI 1477599066
Title
Director
Phone
(812) 477-4444

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X

Addresses

Primary practice location

4847 E Plaza East Blvd
Evansville, IN 47715-2811

Mailing address

4847 E Plaza East Blvd
Evansville, IN 47715-2811
Phone (812) 477-4444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120809000841 IN Part B Supplier - Clinic/Group Practice 8527214303 Receives reassigned benefits from 2 practitioners
Practice locations: Evansville, IN

National Provider Directory

National Provider Directory
Tax ID family
Virginia St Chiropractic PSC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675728000000",
    "number": "1205030152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4847 E PLAZA EAST BLVD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477152811",
            "telephone_number": "812-477-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4847 E PLAZA EAST BLVD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477152811",
            "telephone_number": "812-477-4444",
            "fax_number": "812-477-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA ST CHIROPRACTIC, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "812-477-4444",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; 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.