Nova Ideal Spine

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104556594 Issued in VA

Legal business name

NOVA IDEAL SPINE

Doing business as

Loudoun Family Chiropractic

Practice address

19301 Winmeade Dr Ste 214
Lansdowne, VA 20176-6503

Phone

(571) 707-8639

Fax

(571) 707-8642

NPI assigned

Jul 31, 2017

Organization subpart

No

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

Authorized official

Name

Jeanne Phelps

Title

Office Manager

Phone

(571) 707-8639

Specialties & licenses 1

Addresses

Other names 1

• Loudoun Family Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 1

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.

• Miok Hyoun, D.C.

  • Chiropractor
  • Lansdowne, VA
  • NPI 1700043213
  Medicare reassignment NPD

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

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1205350469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19301 WINMEADE DR STE 214",
            "city": "LANSDOWNE",
            "state": "VA",
            "postal_code": "201766503",
            "telephone_number": "571-707-8639",
            "fax_number": "571-707-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19301 WINMEADE DR STE 214",
            "city": "LANSDOWNE",
            "state": "VA",
            "postal_code": "201766503",
            "telephone_number": "571-707-8639",
            "fax_number": "571-707-8642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA IDEAL SPINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-31",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PHELPS",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "571-707-8639"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Loudoun Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly Lynn Nicoll, M.D.
• Suzanne Elaine Nixon, ED.D.
• Northern Virginia Imaging, LLC
• Northern Virginia Imaging, LLC
• Northland Hearing Centers, Inc. (Ascent Hearing & Audiology)
• Nova Rehabilitation Inc
• Erin Null, OTR/L
• Jennifer Odutola, MD
• Olufunmilola Modupe Ogbonlowo, M.D.
• Oncology/Hematology of Loudoun and Reston, P.C.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.