Kotkin Chiropractic Center PLC – Chiropractor

Key facts

NPI: 1508950452
Entity type: Organization (NPI type 2)
Primary specialty: Chiropractor 111N00000X
License: 0104001317 (VA)
Legal business name: KOTKIN CHIROPRACTIC CENTER PLC
Practice address: 1809 Plaza Drive
Winchester, VA 22601
Phone: (540) 667-7300
Fax: (540) 667-0567
NPI assigned: Oct 3, 2006
Organization subpart: No

Authorized official

Name: Michelle H Kotkin, DC NPI 1376520718
Title: Clinic Owner
Phone: (540) 667-7300

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Michelle Heidi Kotkin, DC Chiropractor · Winchester, VA · NPI 1376520718

Medicare reassignment NPD Authorized official CHIROPRACTOR · VA
Celeste Marie Krawchuk, DC Chiropractor · Berryville, VA · NPI 1558348995

NPD CHIROPRACTOR
Gregory Glen Loy, D.C. Chiropractor · Winchester, VA · NPI 1376600114

NPD (past) CHIROPRACTOR

Medicare participation

Medicare fee-for-service enrollment: Enrolled in VA

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20040207000145	VA	Part B Supplier - Clinic/Group Practice	1951294362	Receives reassigned benefits from 1 practitioner Practice locations: Winchester, VA

National Provider Directory

Locations

1809 Plaza Dr
Winchester, VA 22601
Phone (540) 667-7300

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Chiropractor Group: 193200000X MULTI-SPECIALTY GROUP	111N00000X	0104001317	VA	Yes

Addresses

Primary practice location

1809 Plaza Drive
Winchester, VA 22601

Mailing address

1809 Plaza Drive
Winchester, VA 22607
Phone (540) 667-7300

Other identifiers

Identifier	Type	State	Issuer
0132119000	Medicaid	WV
14521	Other		OPTIMA
0300055	Medicaid	VA
505187	Other		HEALTHLINK NCPPO
203058	Other	VA	BLUE CROSS

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508950452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 PLAZA DRIVE",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "22607",
            "telephone_number": "540-667-7300",
            "fax_number": "540-667-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 PLAZA DRIVE",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "22601",
            "telephone_number": "540-667-7300",
            "fax_number": "540-667-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOTKIN CHIROPRACTIC CENTER PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOTKIN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CLINIC OWNER",
        "authorized_official_telephone_number": "540-667-7300",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104001317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0132119000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA",
            "identifier": "14521",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0300055",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK NCPPO",
            "identifier": "505187",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "203058",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

All providers in Winchester, VA · Chiropractor in Virginia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider 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.