Life Clinic of VA PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

LIFE CLINIC OF VA PC

Practice address

7801 Limestone Dr
Gainesville, VA 20155-4050

Phone

(952) 229-7464

NPI assigned

Jan 31, 2019

Organization subpart

No

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

Authorized official

Name

Reza AlizadehNPI 1538214598

Title

Owner

Phone

(952) 229-7464

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, DC2 enrollments

Enrollment records 2

Locations

Practitioners 1

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

• Reza Pour Alizadeh, D.C.

  • Chiropractor
  • Saint Paul, MN
  • NPI 1538214598

  VA

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1548892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548979200000",
    "number": "1679037972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 549",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553170549",
            "telephone_number": "952-229-7464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7801 LIMESTONE DR",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201554050",
            "telephone_number": "952-229-7464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CLINIC OF VA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-31",
        "last_updated": "2019-02-01",
        "status": "A",
        "authorized_official_last_name": "ALIZADEH",
        "authorized_official_first_name": "REZA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-229-7464"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Lee
• Amanda Lemarier, PT, DPT
• Maria Catalina Lemcke, PT, DPT
• Miriam Saad Lender, MD
• Cornelius Liclic, LPTA
• Life Enrichment Counseling Center, Inc.
• Lifebuoy ABA, LLC (Lifebuoy ABA)
• Lifetime Family Medicine, LLC
• Lighthouse Chiropractic LLC
• Jin Soo Lim, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.