Individual provider Active NPI

Dennis P O'Hara, DC

  • Sports Physician Chiropractor
  • Chantilly, VA
National Provider Identifier
1235229097
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
0104001121 Issued in VA
Practice address
14290 Sullyfield Cir
Suite 100
Chantilly, VA 20151
Phone
(703) 378-0908
Fax
(703) 378-0208
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X XOO9292 NY
Sports Physician Chiropractor 111NS0005X 0104001121 VA Primary

Addresses

Primary practice location

14290 Sullyfield Cir
Suite 100
Chantilly, VA 20151

Mailing address

641 W Lumsden Rd
Brandon, FL 33511-5911
Phone (813) 641-5413

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161129000839 FL Practitioner - Chiropractic 7719075688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Absolute Wellness CenterGroup PAC ID 2163679523, 2 clinicians

Practice addresses (Care Compare)

641 W Lumsden Rd
Brandon, FL 33511-5911
Phone (813) 654-5413

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009292NYMDClinical Psychologist
XOO9292NYMDChiropractor
0104001121VAMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Absolute Wellness Center, LLC CurrentSince Aug 26, 2016 Accepting new patients
Bastien Medical, PLLC PastSince Apr 23, 2023 Accepting new patients
Merckling Family Chiropractic P.C. Chiropractor PastSince Oct 2, 2006 Accepting new patients

Locations

641 W Lumsden Rd
Brandon, FL 33511
Phone (813) 654-5413

13134 Vail Ridge Dr
Riverview, FL 33579
Phone (813) 488-6315

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1235229097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 W LUMSDEN RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115911",
            "telephone_number": "813-641-5413",
            "fax_number": "813-488-6329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14290 SULLYFIELD CIR",
            "address_2": "SUITE 100",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "20151",
            "telephone_number": "703-378-0908",
            "fax_number": "703-378-0208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'HARA",
        "first_name": "DENNIS",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "XOO9292",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "VA",
            "license": "0104001121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chantilly, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; 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.