Individual provider Active NPI

Eric Douglas Terrell, DC

  • Chiropractor
  • Fairfax, VA
National Provider Identifier
1235289075
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104000794 Issued in VA
Practice address
3541 Chain Bridge Rd
Fairfax, VA 22030-2793
Phone
(703) 691-2225
NPI assigned
Jan 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104000794 VA Primary

Addresses

Primary practice location

3541 Chain Bridge Rd
Fairfax, VA 22030-2793

Mailing address

3541 Chain Bridge Rd
Fairfax, VA 22030-2793
Phone (703) 691-2225

Other identifiers 6

IdentifierTypeStateIssuer
FO55OOO1OtherVACAREFIRST
54-1829779OtherVATAX ID
4227400OtherVAAETNA
220381OtherVAANTHEM
440125OtherVAUNITED HEALTHCARE
S5767OtherVAINOVATION HEALTH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090210000399 DC Practitioner - Chiropractic 5294893897 Practice locations: Fairfax, VA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1989
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3541 Chain Bridge Rd
Fairfax, VA 22030-2793
Phone (703) 691-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Chiropractic Clinic Chiropractor PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 1

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320278400000",
    "number": "1235289075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3541 CHAIN BRIDGE RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302793",
            "telephone_number": "703-691-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3541 CHAIN BRIDGE RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302793",
            "telephone_number": "703-691-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRELL",
        "first_name": "ERIC",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2011-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104000794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "FO55OOO1",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "54-1829779",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4227400",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "220381",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "440125",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INOVATION HEALTH",
            "identifier": "S5767",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; 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.