Organization Active NPI

Chiropractic First of Swva Abingdon

  • Clinic/Center
  • Abingdon, VA
National Provider Identifier
1306208731
Registry record updated Dec 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
0104556437 Issued in VA
Legal business name
CHIROPRACTIC FIRST OF SWVA ABINGDON
Practice address
121 Russell Rd NW Ste 1
Abingdon, VA 24210-2758
Phone
(276) 525-1777
NPI assigned
Mar 24, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2016

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

Authorized official

Name
Dr. Randy Bernard Maxwell, D.C.
Title
Cfo/Co-Owner
Phone
(304) 254-4622

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 0104556437 VA Primary

Addresses

Primary practice location

121 Russell Rd NW Ste 1
Abingdon, VA 24210-2758

Mailing address

121 Russell Rd NW Ste 1
Abingdon, VA 24210-2758
Phone (276) 525-1777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170327001719 VA Part B Supplier - Clinic/Group Practice 1557646924 Receives reassigned benefits from 1 practitioner
Practice locations: N Tazewell, VA; Richlands, VA

National Provider Directory

National Provider Directory

Locations

121 Russell Rd NW
#1
Abingdon, VA 24210
Phone (276) 525-1777

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1458777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483056000000",
    "number": "1306208731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 RUSSELL RD NW STE 1",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242102758",
            "telephone_number": "276-525-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 RUSSELL RD NW STE 1",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242102758",
            "telephone_number": "276-525-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC FIRST OF SWVA ABINGDON",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-24",
        "last_updated": "2016-12-30",
        "status": "A",
        "authorized_official_last_name": "MAXWELL",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "BERNARD",
        "authorized_official_title_or_position": "CFO/CO-OWNER",
        "authorized_official_telephone_number": "304-254-4622",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "VA",
            "license": "0104556437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abingdon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.