Individual provider Active NPI

Tanner Jackson Dobrucky, DC

  • Chiropractor
  • Midlothian, VA
National Provider Identifier
1285512590
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104558126 Issued in VA
Practice address
1527 Huguenot Rd # 101
Midlothian, VA 23113-2460
Phone
(804) 955-5194
NPI assigned
Aug 25, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104558126 VA Primary

Addresses

Primary practice location

1527 Huguenot Rd # 101
Midlothian, VA 23113-2460

Mailing address

1527 Huguenot Rd # 101
Midlothian, VA 23113-2460
Phone (804) 955-5194

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260226003110 VA Practitioner - Chiropractic 6406337518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1527 Huguenot Rd
Suite 101
Midlothian, VA 23113-2460
Phone (804) 955-5194

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104558126VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Story Health Collective Chiropractor CurrentSince Jan 23, 2026 Accepting new patients

Locations

1527 Huguenot Rd
#101
Midlothian, VA 23113
Phone (804) 897-9194

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": "1756080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1285512590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1527 HUGUENOT RD # 101",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231132460",
            "telephone_number": "804-955-5194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1527 HUGUENOT RD # 101",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231132460",
            "telephone_number": "804-955-5194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBRUCKY",
        "first_name": "TANNER",
        "middle_name": "JACKSON",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-25",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104558126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.