Individual provider Active NPI

David Alan Packer, D.C.

  • Chiropractor
  • Chesapeake, VA
National Provider Identifier
1417966375
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104556052 Issued in VA
Practice address
1305 Executive Blvd
Ste 170
Chesapeake, VA 23320-3676
Phone
(757) 382-5555
Fax
(757) 382-5556
NPI assigned
Aug 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104556052 VA Primary

Addresses

Primary practice location

1305 Executive Blvd
Ste 170
Chesapeake, VA 23320-3676

Mailing address

1305 Executive Blvd
Ste 170
Chesapeake, VA 23320-3676
Phone (757) 382-5555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081125000784 VA Practitioner - Chiropractic 8224097415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1305 Executive Blvd
Suite 170
Chesapeake, VA 23320-3676
Phone (757) 382-5555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104556052VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Precision Spinal Care, Inc. Chiropractor CurrentSince Oct 1, 2002 Accepting new patients
Precision DME LLC Chiropractor CurrentSince Sep 5, 2018 Accepting new patients

Locations

1305 Executive Blvd
Ste 170
Chesapeake, VA 23320
Phone (757) 382-5555

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417966375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 EXECUTIVE BLVD",
            "address_2": "STE 170",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203676",
            "telephone_number": "757-382-5555",
            "fax_number": "757-382-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 EXECUTIVE BLVD",
            "address_2": "STE 170",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203676",
            "telephone_number": "757-382-5555",
            "fax_number": "757-382-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKER",
        "first_name": "DAVID",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.