Individual provider Active NPI

Perry John Vanderhurst Jr., DC

  • Chiropractor
  • Purcellville, VA
National Provider Identifier
1396709002
Registry record updated Mar 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104001972 Issued in VA
Practice address
205 E Hirst Rd
Suite 102
Purcellville, VA 20132-6198
Phone
(540) 338-3190
Fax
(540) 338-3695
NPI assigned
Apr 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104001972 VA Primary

Addresses

Primary practice location

205 E Hirst Rd
Suite 102
Purcellville, VA 20132-6198

Mailing address

205 E Hirst Rd
Suite 102
Purcellville, VA 20132-6198
Phone (540) 338-3190

Other identifiers 1

IdentifierTypeStateIssuer
434044OtherVAANTHEM BCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121211000391 VA Practitioner - Chiropractic 6305098799 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Ridge Chiropractic and Acupuncture LLCGroup PAC ID 8123270519, 2 clinicians

Practice addresses (Care Compare)

205 Hirst Rd
Suite 102
Purcellville, VA 20132-6199
Phone (540) 338-3190

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104001972VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Chiropractic & Acupuncture, LLC Chiropractor CurrentSince Jan 1, 2007 Accepting new patients

Locations

205 Hirst Rd
Ste 102
Purcellville, VA 20132
Phone (540) 338-3190

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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301443200000",
    "number": "1396709002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 E HIRST RD",
            "address_2": "SUITE 102",
            "city": "PURCELLVILLE",
            "state": "VA",
            "postal_code": "201326198",
            "telephone_number": "540-338-3190",
            "fax_number": "540-338-3695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E HIRST RD",
            "address_2": "SUITE 102",
            "city": "PURCELLVILLE",
            "state": "VA",
            "postal_code": "201326198",
            "telephone_number": "540-338-3190",
            "fax_number": "540-338-3695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERHURST",
        "first_name": "PERRY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2011-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104001972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "434044",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Purcellville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; 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.