Core Pain & Wellness Center LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

CORE PAIN & WELLNESS CENTER LLC

Practice address

10721 Main St Ste G7
Fairfax, VA 22030-6913

Phone

(703) 814-6650

NPI assigned

Jul 25, 2021

Organization subpart

No

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

Authorized official

Name

Peter Taejoo Jeong, DCNPI 1538391750

Title

President

Phone

(703) 814-6650

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Practitioners 1

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

• Peter Taejoo Jeong, DC

  • Chiropractor
  • Fairfax, VA
  • NPI 1538391750

  DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1627171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627171200000",
    "number": "1417620659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10721 MAIN ST STE G7",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306913",
            "telephone_number": "703-814-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10721 MAIN ST STE G7",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306913",
            "telephone_number": "703-814-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORE PAIN & WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-25",
        "last_updated": "2021-07-25",
        "certification_date": "2021-07-25",
        "status": "A",
        "authorized_official_last_name": "JEONG",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "TAEJOO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-814-6650",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul M Corbett, CRNA
• Naomi Melissa Corbi, RN
• Hadley Archer Corcoran, LCSW
• Kimberly Corcoran
• Valerie Cordero, M.ED., ED.S
• Ana Coreas
• Jeniffer Corena
• Julia Corio
• Leila A Corker, PA-C
• Erica Cornelius, LPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2021; 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.