Stephen Lewis Childress I, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104001354 Issued in VA

Practice address

619 W Main St Ste B
Lebanon, VA 24266-3809

Phone

(276) 889-1314

Fax

(276) 889-4125

NPI assigned

May 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493942400000",
    "number": "1285684332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1300",
            "address_2": "307 W MAIN STREET",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "24266",
            "telephone_number": "276-889-2200",
            "fax_number": "276-889-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 W MAIN ST STE B",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "242663809",
            "telephone_number": "276-889-1314",
            "fax_number": "276-889-4125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDRESS",
        "first_name": "STEPHEN",
        "middle_name": "LEWIS",
        "name_suffix": "I",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2017-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104001354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "236332",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0300608",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5010623",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Isabella Cantrell, LPC
• Richard Wayne Carroll Jr., PH.D., L.P.C.
• Alfredo Cervantes, MD
• Helen Audra Chafin-Hobert
• Childress Chiropractic, Spinal Rehab & Wellness
• Choice Respiratory & Medical Equipment, Inc.
• Jackie A Church, APN
• Amy Clear, LPC
• Kacie Click
• Robert Joseph Cole, P.T.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.