Individual provider Active NPI

Jaren Panick, DC

  • Chiropractor
  • Williamsburg, VA
National Provider Identifier
1386454627
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104558041 Issued in VA
Practice address
1307 Jamestown Rd Ste 103
Williamsburg, VA 23185-3381
Phone
(757) 229-4161
NPI assigned
Jan 9, 2025
Last updated
Jan 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104558041 VA Primary

Addresses

Primary practice location

1307 Jamestown Rd Ste 103
Williamsburg, VA 23185-3381

Mailing address

114 Bimini LN
Williamsburg, VA 23188-2000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250204001417 VA Practitioner - Chiropractic 8022548288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Performance Chiropractic LLCGroup PAC ID 4385735000, 2 clinicians

Practice addresses (Care Compare)

1307 Jamestown Rd
Suite 103
Williamsburg, VA 23185-3381
Phone (757) 229-4161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104558041VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Chiropractic, LLC Chiropractor CurrentSince Jan 3, 2025 Accepting new patients

Locations

1307 Jamestown Rd
Ste 103
Williamsburg, VA 23185
Phone (757) 218-2369

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, 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": "1736380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1386454627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 BIMINI LN",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231882000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 JAMESTOWN RD STE 103",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231853381",
            "telephone_number": "757-229-4161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANICK",
        "first_name": "JAREN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-09",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104558041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; 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.