Individual provider Active NPI

George N Bakalis, D.C.

  • Chiropractor
  • Woodbridge, VA
National Provider Identifier
1508868225
Registry record updated Mar 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104000545 Issued in VA
Practice address
2026B Opitz Blvd
Woodbridge, VA 22191-3306
Phone
(703) 491-8888
Fax
(703) 491-2244
NPI assigned
Aug 12, 2005
Last updated
Mar 12, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104000545 VA Primary

Addresses

Primary practice location

2026B Opitz Blvd
Woodbridge, VA 22191-3306

Mailing address

2026B Opitz Blvd
Woodbridge, VA 22191-3306
Phone (703) 491-8888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110421000453 VA Practitioner - Chiropractic 5597940353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1985
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2026 Opitz Blvd B
Woodbridge, VA 22191-3332
Phone (703) 491-8888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104000545VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Prince William Chiropractic Clinic Inc CurrentSince Jan 1, 1989 Accepting new patients

Locations

2026 Opitz Blvd
Ste B
Woodbridge, VA 22191
Phone (703) 491-8888

Organizations & group practices 1

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": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205280000000",
    "number": "1508868225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2026B OPITZ BLVD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913306",
            "telephone_number": "703-491-8888",
            "fax_number": "703-491-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2026B OPITZ BLVD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913306",
            "telephone_number": "703-491-8888",
            "fax_number": "703-491-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKALIS",
        "first_name": "GEORGE",
        "middle_name": "N",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2008-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104000545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; 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.