Organization Active NPI

Chiropractic Care and Rehab of Northern Virginia

  • Chiropractor
  • Springfield, VA
National Provider Identifier
1508122862
Registry record updated Aug 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104556224 Issued in VA
Legal business name
CHIROPRACTIC CARE AND REHAB OF NORTHERN VIRGINIA
Practice address
8136 Old Keene Mill Road
A-314
Springfield, VA 22152
Phone
(703) 644-9311
Fax
(703) 644-3907
NPI assigned
Apr 11, 2012
Last updated
Aug 20, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2013

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

Authorized official

Name
Dr. Peter Victor Boyer, D.C.NPI 1295812550
Title
Manager
Phone
(703) 644-9311

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
Chiropractor 111N00000X 0104556224 VA Primary

Addresses

Primary practice location

8136 Old Keene Mill Road
A-314
Springfield, VA 22152

Mailing address

8136 Old Keene Mill Road
A-314
Springfield, VA 22152
Phone (703) 644-9311

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120328000514 DC Part B Supplier - Clinic/Group Practice 5092975029 Receives reassigned benefits from 1 practitioner
Practice locations: Springfield, VA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1334102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376956800000",
    "number": "1508122862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8136 OLD KEENE MILL ROAD",
            "address_2": "A-314",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "22152",
            "telephone_number": "703-644-9311",
            "fax_number": "703-644-3907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8136 OLD KEENE MILL ROAD",
            "address_2": "A-314",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "22152",
            "telephone_number": "703-644-9311",
            "fax_number": "703-644-3907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC CARE AND REHAB OF NORTHERN VIRGINIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-11",
        "last_updated": "2013-08-20",
        "status": "A",
        "authorized_official_last_name": "BOYER",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "VICTOR",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "703-644-9311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; 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.