Bryan Lichtenauer, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104-557702 Issued in VA

Practice address

43150 Broadlands Center PLZ Ste 154
Broadlands, VA 20148-3801

Phone

(571) 888-5045

NPI assigned

Feb 4, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Chiropractic

Education

Life Chiropractic College, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1612396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1285226985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43150 BROADLANDS CENTER PLZ STE 154",
            "city": "BROADLANDS",
            "state": "VA",
            "postal_code": "201483801",
            "telephone_number": "571-319-6768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43150 BROADLANDS CENTER PLZ STE 154",
            "city": "BROADLANDS",
            "state": "VA",
            "postal_code": "201483801",
            "telephone_number": "571-888-5045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9649 Fairfax Blvd",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220312321",
            "country_code": "US",
            "telephone_number": "443-632-5035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LICHTENAUER",
        "first_name": "BRYAN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-04",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104-557702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina M Laura
• Dena Lee
• Irene Lee
• Mary Leidy
• Andrew Levy
• Theresa Ann Lichtman, PH.D.
• Lighthouse Chiropractic and Rehab
• James Lilly
• Pamela Mara Lindo
• April Lisbon-Peoples

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.