Individual provider Active NPI

Jason R Brown, D.C.

  • Chiropractor
  • Reston, VA
National Provider Identifier
1316229032
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104001853 Issued in VA
Practice address
11700 Bowman Green Dr
Reston, VA 20190-3501
Phone
(703) 489-5038
NPI assigned
Sep 20, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104001853 VA Primary

Addresses

Primary practice location

11700 Bowman Green Dr
Reston, VA 20190-3501

Mailing address

11700 Bowman Green Dr
Reston, VA 20190-3501
Phone (703) 489-5038

Other practice location 1

6969 Richmond Hwy
Alexandria, VA 22306-1839
Phone (703) 721-0500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150521000034 DC Practitioner - Chiropractic 5597085225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11700 Bowman Green Dr
Reston, VA 20190-3501
Phone (571) 485-5793

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104001853VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Reston Chiropractic Group LLC Chiropractor CurrentSince Aug 14, 2020 Accepting new patients
Bodnar Chiropractic Center Inc Chiropractor PastSince Apr 1, 2002 Accepting new patients

Locations

11700 Bowman Green Dr
Reston, VA 20190
Phone (571) 375-2630

Organizations & group practices 2

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": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1316229032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11700 BOWMAN GREEN DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903501",
            "telephone_number": "703-489-5038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11700 BOWMAN GREEN DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903501",
            "telephone_number": "703-489-5038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6969 Richmond Hwy",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223061839",
            "country_code": "US",
            "telephone_number": "703-721-0500",
            "fax_number": "703-721-0534",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JASON",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-20",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104001853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.