Individual provider Active NPI

Donald Patrick Bresnahan, D.C.

  • Chiropractor
  • Virginia Beach, VA
National Provider Identifier
1376580308
Registry record updated Apr 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
104000492 Issued in VA
Practice address
1917 Laskin Rd
Suite 108
Virginia Beach, VA 23454-4283
Phone
(757) 491-4600
Fax
(757) 491-0578
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 104000492 VA Primary

Addresses

Primary practice location

1917 Laskin Rd
Suite 108
Virginia Beach, VA 23454-4283

Mailing address

1917 Laskin Rd
Suite 108
Virginia Beach, VA 23454-4283
Phone (757) 491-4600

Other identifiers 2

IdentifierTypeStateIssuer
P00116450OtherVARAILROAD MEDICARE PTAN
043307OtherVAANTHEM BCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071016000301 VA Practitioner - Chiropractic 6507952975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1917 Laskin Rd
Suite 108
Virginia Beach, VA 23454-4283
Phone (757) 491-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
104000492VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Messiah & Son, Inc. Chiropractor CurrentSince Oct 1, 2006 Accepting new patients

Locations

1917 Laskin Rd
Ste 108
Virginia Beach, VA 23454
Phone (757) 491-4600

Organizations & group practices 1

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209081600000",
    "number": "1376580308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1917 LASKIN RD",
            "address_2": "SUITE 108",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234544283",
            "telephone_number": "757-491-4600",
            "fax_number": "757-491-0578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1917 LASKIN RD",
            "address_2": "SUITE 108",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234544283",
            "telephone_number": "757-491-4600",
            "fax_number": "757-491-0578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRESNAHAN",
        "first_name": "DONALD",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2008-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "104000492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P00116450",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "043307",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; 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.