Individual provider Active NPI

Ellen Fitzenrider, DC

  • Chiropractor
  • Arlington, VA
National Provider Identifier
1457303612
Registry record updated Sep 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104555721 Issued in VA
Practice address
3033 Wilson Blvd Ste 700
Arlington, VA 22201-3868
Phone
(703) 963-4257
NPI assigned
May 16, 2006
Last updated
Sep 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104555721 VA Primary
Chiropractor 111N00000X 104555721 VA

Addresses

Primary practice location

3033 Wilson Blvd Ste 700
Arlington, VA 22201-3868

Mailing address

3033 Wilson Blvd Ste 700
Arlington, VA 22201-3868
Phone (703) 963-4257

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Arlington Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220715001448 DC Practitioner - Chiropractic 5294759783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

923 N Kenmore St
Arlington, VA 22201-2226
Phone (703) 963-4257

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104555721VAMDChiropractor
104555721VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
The Shift With Dr. Ellen Chiropractor CurrentSince Mar 9, 2022 Accepting new patients
Dynamic Health Solutions Chiropractor PastSince Jul 1, 2013 Accepting new patients

Locations

3033 Wilson Blvd
Ste 700
Arlington, VA 22201
Phone (202) 410-5972

923 N Kenmore St
Arlington, VA 22201
Phone (703) 963-4257

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1457303612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 WILSON BLVD STE 700",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222013868",
            "telephone_number": "703-963-4257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 WILSON BLVD STE 700",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222013868",
            "telephone_number": "703-963-4257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZENRIDER",
        "first_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104555721",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "104555721",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Arlington",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3033 Wilson Blvd Ste 700",
            "city": "Arlington",
            "state": "VA",
            "country_code": "US",
            "postal_code": "222013868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; 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.