Mountain Spring Chiropractic Center Inc
Organization Active NPI Chiropractor · Crimora, VA
NPI 1407976806 · NPPES record last updated Apr 22, 2008
Key facts
- NPI
- 1407976806
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- MOUNTAIN SPRING CHIROPRACTIC CENTER INC
- Practice address
- 1648 New Hope Crimora Road
Crimora, VA 24431-0246 - Phone
- (540) 943-0022
- Fax
- (540) 942-3330
- NPI assigned
- Mar 30, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Elizabeth Kautz Koch, DC
- Title
- Owner
- Phone
- (540) 943-0022
Practitioners 1
-
Elizabeth V Kautz Koch, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080410000265 | VA | Part B Supplier - Clinic/Group Practice | 8820175151 |
Receives reassigned benefits from 1 practitioner Practice locations: Fishersville, VA |
National Provider Directory
Locations
1569 Jefferson Hwy
Ste 105
Fishersville, VA 22939
Phone (540) 943-0022
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | VA | Yes |
Addresses
Primary practice location
1648 New Hope Crimora Road
Crimora, VA 24431-0246
Mailing address
PO Box 246
Crimora, VA 24431-0246
Phone (540) 943-0022
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 261199 | Other | VA | ANTHEM |
| 269523 | Other | VA | SOUTHERN HEALTH |
Other providers in Crimora, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.