Nova Functional Sports Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

NOVA FUNCTIONAL SPORTS CHIROPRACTIC LLC

Practice address

44645 Guilford Dr Ste 211
Ashburn, VA 20147-6020

Phone

(315) 577-2427

NPI assigned

May 20, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Jane Ellen Pavalkis, DCNPI 1295199370

Title

Doctor of Chiropractic

Phone

(315) 577-2427

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 1

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

• Jane Pavalkis, D.C

  • Chiropractor
  • Ashburn, VA
  • NPI 1295199370
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654560000000",
    "number": "1518532829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44645 GUILFORD DR STE 211",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201476020",
            "telephone_number": "703-831-7036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44645 GUILFORD DR STE 211",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201476020",
            "telephone_number": "315-577-2427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA FUNCTIONAL SPORTS CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-20",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A",
        "authorized_official_last_name": "PAVALKIS",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "315-577-2427",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; 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.