Performance Health Center, PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104556458 Issued in VA

Legal business name

PERFORMANCE HEALTH CENTER, PLLC

Practice address

5288 Lyngate CT
Burke, VA 22015-1688

Phone

(703) 912-7822

Fax

(703) 995-0357

NPI assigned

Dec 31, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Todd Sullivan Sullivan, D.C.

Title

Owner/Doctor

Phone

(703) 912-7822

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Todd Patrick Sullivan, D.C.

  • Chiropractor
  • Burke, VA
  • NPI 1235119959

  DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532908800000",
    "number": "1386829000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5288 LYNGATE CT",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220151688",
            "telephone_number": "703-912-7822",
            "fax_number": "703-995-0357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5288 LYNGATE CT",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220151688",
            "telephone_number": "703-912-7822",
            "fax_number": "703-995-0357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE HEALTH CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-31",
        "last_updated": "2018-07-30",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "SULLIVAN",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "703-912-7822",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Natalie Perez
• Sylvia Perry, BCBA, LBA
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• Kimberly Phillips, FNP-BC
• Nhu-Quynh Phung, D.M.D.
• Douglas David Piccolo, RPH

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2018; 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.