Organization Active NPI

Clegg Chiropractic P C

  • Orthopedic Chiropractor
  • Leesburg, VA
National Provider Identifier
1457319907
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
E-00 Issued in VA
Legal business name
CLEGG CHIROPRACTIC P C
Practice address
225 Loudoun St SE
Leesburg, VA 20175-3115
Phone
(703) 777-8884
Fax
(703) 777-9071
NPI assigned
May 3, 2006
Last updated
Jul 21, 2022By the provider in NPPES
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. Charles R. Clegg, D. C.NPI 1457309700
Title
Owner
Phone
(703) 777-8884

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
Orthopedic ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NX0800X E-00 VA Primary

Addresses

Primary practice location

225 Loudoun St SE
Leesburg, VA 20175-3115

Mailing address

225 Loudoun St SE
Leesburg, VA 20175-3115
Phone (703) 777-8884

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090721000107 VA Part B Supplier - Clinic/Group Practice 3870645328 Receives reassigned benefits from 3 practitioners
Practice locations: Leesburg, VA

National Provider Directory

National Provider Directory

Locations

225 Loudoun St SE
Leesburg, VA 20175
Phone (703) 777-8884

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1457319907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 LOUDOUN ST SE",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201753115",
            "telephone_number": "703-777-8884",
            "fax_number": "703-777-9071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 LOUDOUN ST SE",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201753115",
            "telephone_number": "703-777-8884",
            "fax_number": "703-777-9071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEGG CHIROPRACTIC P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CLEGG",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-777-8884",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D. C."
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Orthopedic",
            "state": "VA",
            "license": "E-00",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, 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.