Jefferson Davis Chiropractic & PT

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104001683 Issued in VA

Legal business name

JEFFERSON DAVIS CHIROPRACTIC & PT

Practice address

14904 Jefferson Davis Hwy
#301
Woodbridge, VA 22191

Phone

(703) 499-8840

Fax

(703) 499-8842

NPI assigned

Feb 13, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sara Hatam Peterson, DC

Title

Owner Chiropractor

Phone

(703) 499-8840

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Derek Carroll Curran, D.C.

  • Chiropractor
  • Edgewater, MD
  • NPI 1780933143
  NPD (past)

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336281518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14904 JEFFERSON DAVIS HWY",
            "address_2": "#301",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "22102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14904 JEFFERSON DAVIS HWY",
            "address_2": "#301",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "22191",
            "telephone_number": "703-499-8840",
            "fax_number": "703-499-8842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON DAVIS CHIROPRACTIC & PT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "HATAM",
        "authorized_official_title_or_position": "OWNER CHIROPRACTOR",
        "authorized_official_telephone_number": "703-499-8840",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104001683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.