Organization Active NPI

Glide Chiropractic Care

  • Chiropractor
  • Herndon, VA
National Provider Identifier
1386421113
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
GLIDE CHIROPRACTIC CARE
Practice address
1039 Sterling Rd Ste 101
Herndon, VA 20170-3840
Phone
(571) 306-7641
Fax
(571) 313-3598
NPI assigned
Sep 14, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Authorized official

Name
Dr. Lily Moezi-Vaziri, DCNPI 1194910877
Title
Owner
Phone
(571) 306-7641

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1039 Sterling Rd Ste 101
Herndon, VA 20170-3840

Mailing address

1039 Sterling Rd Ste 101
Herndon, VA 20170-3840
Phone (571) 306-7641

Other names 1

  • Glide Chiropractic Care LLC Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231010001594 DC Part B Supplier - Clinic/Group Practice 7517312614 Receives reassigned benefits from 1 practitioner
Practice locations: Herndon, VA

National Provider Directory

National Provider Directory

Locations

1039 Sterling Rd
Ste 101
Herndon, VA 20170
Phone (571) 306-7641

Practitioners & affiliated clinicians

Practitioners 1

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": "1694649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1386421113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1039 STERLING RD STE 101",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201703840",
            "telephone_number": "571-306-7641",
            "fax_number": "571-313-3598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1039 STERLING RD STE 101",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201703840",
            "telephone_number": "571-306-7641",
            "fax_number": "571-313-3598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLIDE CHIROPRACTIC CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-14",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A",
        "authorized_official_last_name": "MOEZI-VAZIRI",
        "authorized_official_first_name": "LILY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "571-306-7641",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glide Chiropractic Care LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Herndon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; 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.