NPIMap

Organization Active NPI

Divine Spine Chiropractic

  • Chiropractor
  • Prince George, VA
National Provider Identifier
1598173155
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104-557187 Issued in VA
Legal business name
DIVINE SPINE CHIROPRACTIC
Practice address
4205 Crossings Blvd
Prince George, VA 23875
Phone
(804) 668-5918
NPI assigned
Jul 28, 2014
Last updated
Sep 30, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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

Authorized official

Name
Dr. Braheem Z Tolbert, DCNPI 1861809907
Title
Owner
Phone
(804) 668-5918

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104-557187 VA Primary

Addresses

Primary practice location

4205 Crossings Blvd
Prince George, VA 23875

Mailing address

4205 Crossings Blvd
Prince George, VA 23875
Phone (804) 668-5918

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412035200000",
    "number": "1598173155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 CROSSINGS BLVD",
            "city": "PRINCE GEORGE",
            "state": "VA",
            "postal_code": "23875",
            "telephone_number": "804-668-5918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 CROSSINGS BLVD",
            "city": "PRINCE GEORGE",
            "state": "VA",
            "postal_code": "23875",
            "telephone_number": "804-668-5918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE SPINE CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-28",
        "last_updated": "2014-09-30",
        "status": "A",
        "authorized_official_last_name": "TOLBERT",
        "authorized_official_first_name": "BRAHEEM",
        "authorized_official_middle_name": "Z",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-668-5918",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104-557187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince George, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.