Individual provider Active NPI

Samuel Colt Brinkley, D.C.

  • Rehabilitation Chiropractor
  • Henrico, VA
National Provider Identifier
1477757888
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
0104556593 Issued in VA
Practice address
3400 Haydenpark LN Ste 300
Henrico, VA 23233-7867
Phone
(800) 404-6050
Fax
(866) 313-3397
NPI assigned
Jun 12, 2007
Last updated
Nov 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 0104556593 VA Primary

Addresses

Primary practice location

3400 Haydenpark LN Ste 300
Henrico, VA 23233-7867

Mailing address

PO Box 700688
San Antonio, TX 78270-0688
Phone (210) 318-3007

Other identifiers 1

IdentifierTypeStateIssuer
0104556593OtherVACHIROPRACTIC LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address records@airrosti-rehab-ctrs.direct.kno2fy.com Airrosti Rehab Centers, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104556593VAMDRehabilitation Chiropractor

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1477757888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 700688",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782700688",
            "telephone_number": "210-318-3007",
            "fax_number": "210-468-0682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 HAYDENPARK LN STE 300",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232337867",
            "telephone_number": "800-404-6050",
            "fax_number": "866-313-3397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINKLEY",
        "first_name": "SAMUEL",
        "middle_name": "COLT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "VA",
            "license": "0104556593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC LICENSE",
            "identifier": "0104556593",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "records@airrosti-rehab-ctrs.direct.kno2fy.com",
            "affiliation": "Y",
            "affiliationName": "Airrosti Rehab Centers, LLC",
            "address_1": "111 Tower Dr Bldg 1",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782323625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Henrico, VA

Sources for this page

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