Individual provider Active NPI

Shayda Mankooei, D.C.

  • Chiropractor
  • Springfield, VA
National Provider Identifier
1568495661
Registry record updated Jun 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104555961 Issued in VA
Practice address
6800 Backlick Rd
Suite 100
Springfield, VA 22150-3070
Phone
(703) 644-5900
Fax
(703) 644-5902
NPI assigned
Jul 9, 2006
Last updated
Jun 9, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104555961 VA Primary

Addresses

Primary practice location

6800 Backlick Rd
Suite 100
Springfield, VA 22150-3070

Mailing address

6800 Backlick Rd
Suite 100
Springfield, VA 22150-3070
Phone (703) 644-5900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190903001624 DC Practitioner - Chiropractic 2668701525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6800 Backlick Rd
Suite 100
Springfield, VA 22150-3069
Phone (703) 644-5900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402272000000",
    "number": "1568495661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 BACKLICK RD",
            "address_2": "SUITE 100",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221503070",
            "telephone_number": "703-644-5900",
            "fax_number": "703-644-5902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 BACKLICK RD",
            "address_2": "SUITE 100",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221503070",
            "telephone_number": "703-644-5900",
            "fax_number": "703-644-5902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANKOOEI",
        "first_name": "SHAYDA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2014-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104555961",
            "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 Jun 9, 2014; 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.