Jacob Michael Sunderlage, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104-557743 Issued in VA

Practice address

7350 Peppers Ferry Blvd Ste B
Fairlawn, VA 24141-8999

Phone

(540) 731-4357

NPI assigned

Aug 30, 2021

Last updated

Aug 30, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Eric R Hartman, DC, PLLC

  • Chiropractor
  • Jenison, MI
  • NPI 1982886776
  Medicare reassignment NPD
• Strength Spine, Sport and Performance PLLC

  • Chiropractor
  • Grand Rapids, MI
  • NPI 1780579391
  NPD Authorized official
• Tuck Chiropractic Corporation

  dba Tuck WorkWell

  • Family Medicine Physician
  • Roanoke, VA
  • NPI 1578155610
  NPD (past)
• Tuck Clinic of Chiropractic

  • Chiropractor
  • Pulaski, VA
  • NPI 1447317870
  NPD (past)

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1497422174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 S MAIN ST STE 5",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240606628",
            "telephone_number": "540-951-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7350 PEPPERS FERRY BLVD STE B",
            "city": "FAIRLAWN",
            "state": "VA",
            "postal_code": "241418999",
            "telephone_number": "540-731-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDERLAGE",
        "first_name": "JACOB",
        "middle_name": "MICHAEL",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-30",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104-557743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Polaski County Board of Supervisors
• Benjamin Carroll Poovey
• Lisa Pugh, LPC
• Gershon Silber, M.D.
• Stephanie Whited, LCSW LLC
• Tri-Medical LLC
• Virginia Highland Health PC
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2762)
• Wal-Mart Stores East, LP (Vision Center 30-2762)
• Ashley Williams, PHARMD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; 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.