Innate Fusion, PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104557018 Issued in VA

Legal business name

INNATE FUSION, PC

Practice address

380 Maple Ave W
Suite L3
Vienna, VA 22180-5620

Phone

(703) 242-0030

NPI assigned

Oct 29, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Douglas Paul Knapp, D.C.

Title

Director

Phone

(703) 242-0030

Specialties & licenses 2

Addresses

Other names 1

• InnateFUSION - Concierge Chiropractic Doing business as

Locations

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

{
    "created_epoch": "1383004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390003200000",
    "number": "1548698665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 MAPLE AVE W",
            "address_2": "SUITE L3",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221805620",
            "telephone_number": "703-242-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 MAPLE AVE W",
            "address_2": "SUITE L3",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221805620",
            "telephone_number": "703-242-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNATE FUSION, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-29",
        "last_updated": "2014-01-18",
        "status": "A",
        "authorized_official_last_name": "KNAPP",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "703-242-0030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104557018",
            "primary": true
        },
        {
            "code": "111NI0013X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Independent Medical Examiner",
            "state": "VA",
            "license": "0104557018",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "InnateFUSION - Concierge Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chiropractor in Vienna, VA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.