Organization Active NPI

Valley Chiropractic LLC

  • Chiropractor
  • Frederick, MD
National Provider Identifier
1629260575
Registry record updated Jul 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S02048 Issued in MD
Legal business name
VALLEY CHIROPRACTIC LLC
Practice address
110 Baughmans LN Ste 200
Frederick, MD 21702-4916
Phone
(301) 624-0024
Fax
(301) 624-0026
NPI assigned
Aug 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2019

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

Authorized official

Name
Dr. Dennis R. Travagline, D.C.NPI 1093713281
Title
Owner
Phone
(310) 624-0024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X S02048 MD Primary

Addresses

Primary practice location

110 Baughmans LN Ste 200
Frederick, MD 21702-4916

Mailing address

110 Baughmans LN Ste 200
Frederick, MD 21702-4916
Phone (301) 624-0024

Other identifiers 2

IdentifierTypeStateIssuer
J571-0001OtherDCCAREFIRST BC/BS
1584302OtherMDCAREFIRST BC/BS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040616000194 MD Part B Supplier - Clinic/Group Practice 7214911361 Receives reassigned benefits from 4 practitioners
Practice locations: Frederick, MD

National Provider Directory

National Provider Directory

Locations

110 Baughmans Ln
Ste 200
Frederick, MD 21702
Phone (301) 624-0024

4 S McCain Dr
Ste 8
Frederick, MD 21703
Phone (301) 624-0024

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564444800000",
    "number": "1629260575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 BAUGHMANS LN STE 200",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024916",
            "telephone_number": "301-624-0024",
            "fax_number": "301-624-0026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BAUGHMANS LN STE 200",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024916",
            "telephone_number": "301-624-0024",
            "fax_number": "301-624-0026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-14",
        "last_updated": "2019-07-30",
        "status": "A",
        "authorized_official_last_name": "TRAVAGLINE",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-624-0024",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S02048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BC/BS",
            "identifier": "J571-0001",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BC/BS",
            "identifier": "1584302",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2019; 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.