Individual provider Active NPI

Rebekah Fortenberry, DC

  • Chiropractor
  • Chesapeake, VA
National Provider Identifier
1376398768
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104557990 Issued in VA
Practice address
1108 Madison PLZ
Chesapeake, VA 23320-5111
Phone
(757) 436-5428
NPI assigned
Apr 19, 2024
Last updated
Apr 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104557990 VA Primary

Addresses

Primary practice location

1108 Madison PLZ
Chesapeake, VA 23320-5111

Mailing address

1108 Madison PLZ
Chesapeake, VA 23320-5111
Phone (757) 436-5428

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240508003304 VA Practitioner - Chiropractic 3870934821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
David N Block IncGroup PAC ID 8022286673, 4 clinicians

Practice addresses (Care Compare)

1108 Madison PLZ
Chesapeake, VA 23320-5111
Phone (757) 436-5428

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
David N. Block, Inc Chiropractor CurrentSince Apr 22, 2024 Accepting new patients
Damin, Inc Chiropractor PastSince Apr 21, 2024 Accepting new patients

Locations

1108 Madison Plz
Chesapeake, VA 23320
Phone (757) 436-5428

1108 Madison Plz
Ste 102
Chesapeake, VA 23320

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1713484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1376398768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 MADISON PLZ",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233205111",
            "telephone_number": "757-436-5428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 MADISON PLZ",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233205111",
            "telephone_number": "757-436-5428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTENBERRY",
        "first_name": "REBEKAH",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-19",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104557990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; 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.