Organization Active NPI

Jubilee Family Chiropractic, LLC

  • Chiropractor
  • Charlottesville, VA
National Provider Identifier
1447788914
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104-557424 Issued in VA
Legal business name
JUBILEE FAMILY CHIROPRACTIC, LLC
Practice address
1770 Timberwood Blvd Ste 103
Charlottesville, VA 22911-7501
Phone
(434) 218-2620
NPI assigned
May 30, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Lisa Michelle WilliamsNPI 1699203166
Title
Owner
Phone
(434) 218-2620

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 0104-557424 VA Primary

Addresses

Primary practice location

1770 Timberwood Blvd Ste 103
Charlottesville, VA 22911-7501

Mailing address

1770 Timberwood Blvd Ste 103
Charlottesville, VA 22911-7501
Phone (434) 218-2620

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170828003197 VA Part B Supplier - Clinic/Group Practice 9234401126 Receives reassigned benefits from 1 practitioner
Practice locations: Charlottesville, VA

National Provider Directory

National Provider Directory

Locations

1770 Timberwood Blvd
Ste 103
Charlottesville, VA 22911
Phone (434) 218-2620

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1496102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1447788914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 TIMBERWOOD BLVD STE 103",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229117501",
            "telephone_number": "434-218-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 TIMBERWOOD BLVD STE 103",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229117501",
            "telephone_number": "434-218-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUBILEE FAMILY CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-30",
        "last_updated": "2022-07-21",
        "certification_date": "2021-11-05",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "434-218-2620",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104-557424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.