Individual provider Active NPI

Maribel Vazquez, D.C

  • Rehabilitation Chiropractor
  • Sterling, VA
National Provider Identifier
1407061674
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
0104555757 Issued in VA
Practice address
2 Pidgeon Hill Dr
Suite 280
Sterling, VA 20165-6149
Phone
(703) 404-1807
Fax
(703) 404-1827
NPI assigned
May 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 0104555757 VA Primary

Addresses

Primary practice location

2 Pidgeon Hill Dr
Suite 280
Sterling, VA 20165-6149

Mailing address

2 Pidgeon Hill Dr
Suite 280
Sterling, VA 20165-6145
Phone (703) 404-1807

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081121000680 VA Practitioner - Chiropractic 6608779368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1999
Medicare assignment
May accept Medicare assignment
Group practices
TgvpcGroup PAC ID 8224198122, 2 clinicians

Practice addresses (Care Compare)

2 Pidgeon Hill Dr
Suite 280
Sterling, VA 20165-6149
Phone (703) 404-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104555757VAMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Tgvpc Rehabilitation CurrentSince Dec 17, 2007 Accepting new patients
Alternative Wellness Clinic Rehabilitation PastSince Dec 17, 2007 Accepting new patients

Locations

2 Pidgeon Hill Dr
Ste 280
Sterling, VA 20165
Phone (703) 404-1807

Organizations & group practices 2

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": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210809600000",
    "number": "1407061674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PIDGEON HILL DR",
            "address_2": "SUITE 280",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201656145",
            "telephone_number": "703-404-1807",
            "fax_number": "703-404-1827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PIDGEON HILL DR",
            "address_2": "SUITE 280",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201656149",
            "telephone_number": "703-404-1807",
            "fax_number": "703-404-1827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "MARIBEL",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2008-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "VA",
            "license": "0104555757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.