Organization Active NPI

Reynolds Chiropractic, LLC

  • Chiropractor
  • Roanoke, VA
National Provider Identifier
1225756067
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
REYNOLDS CHIROPRACTIC, LLC
Practice address
1231 Maple Ave SW
Roanoke, VA 24016-4707
Phone
(540) 342-9445
Fax
(540) 342-9446
NPI assigned
Aug 18, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Authorized official

Name
Dr. Dale Eugene Reynolds, DCNPI 1881732014
Title
Owner
Phone
(540) 342-9445

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1231 Maple Ave SW
Roanoke, VA 24016-4707

Mailing address

1231 Maple Ave SW
Roanoke, VA 24016-4707
Phone (540) 342-9445

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221104001420 VA Part B Supplier - Clinic/Group Practice 1254708191 Receives reassigned benefits from 1 practitioner
Practice locations: Roanoke, VA

National Provider Directory

National Provider Directory

Locations

1231 Maple Ave SW
Roanoke, VA 24016
Phone (540) 342-9445

Practitioners & affiliated clinicians

Practitioners 2

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": "1660780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660780800000",
    "number": "1225756067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 MAPLE AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164707",
            "telephone_number": "540-342-9445",
            "fax_number": "540-342-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 MAPLE AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164707",
            "telephone_number": "540-342-9445",
            "fax_number": "540-342-9446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REYNOLDS CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-342-9445",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.