Matthew B Shifflett, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104556015 Issued in VA

Practice address

56 Irvington Road
#1
Kilmarnock, VA 22482-1335

Phone

(804) 435-2273

Fax

(804) 436-0143

NPI assigned

Mar 17, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Pure N' Simple Family Chiropractic, Inc

  • Chiropractor
  • Kilmarnock, VA
  • NPI 1235300336
  NPD (past) Authorized official

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206403200000",
    "number": "1437320629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1335",
            "city": "KILMARNOCK",
            "state": "VA",
            "postal_code": "224821335",
            "telephone_number": "804-435-2273",
            "fax_number": "804-436-0143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 IRVINGTON ROAD",
            "address_2": "#1",
            "city": "KILMARNOCK",
            "state": "VA",
            "postal_code": "224821335",
            "telephone_number": "804-435-2273",
            "fax_number": "804-436-0143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIFFLETT",
        "first_name": "MATTHEW",
        "middle_name": "B",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-17",
        "last_updated": "2008-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "0104556015",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan A. Rose, CCC-SLP
• Julie Saccogna, MA, CCC-SLP
• James Thomas Saunders II, R.PH.
• Denise Schindler, CPNP
• Latesha Scott
• Steven John Short, DDS
• Emma Grace Sisson, RBT
• Christina Mary Slavin, FNP
• Praisya Smith, DPT, PT
• Janine Snader, LPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.