Individual provider Active NPI

Susan Elaine Richards, DC

  • Chiropractor
  • Virginia Beach, VA
National Provider Identifier
1679543144
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104556450 Issued in VA
Practice address
2000 General Booth Blvd
Suite #101
Virginia Beach, VA 23454-5876
Phone
(757) 430-0990
Fax
(757) 430-6860
NPI assigned
Jan 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2558 OH
Chiropractor 111N00000X 0104556450 VA Primary

Addresses

Primary practice location

2000 General Booth Blvd
Suite #101
Virginia Beach, VA 23454-5876

Mailing address

4639 Glencoe LN
Virginia Beach, VA 23464-6373
Phone (757) 309-6679

Other identifiers 1

IdentifierTypeStateIssuer
2234399MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2558OHMDChiropractor
0104556450VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
MSP Inc. Chiropractor PastSince Jan 1, 2003 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1679543144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4639 GLENCOE LN",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234646373",
            "telephone_number": "757-309-6679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 GENERAL BOOTH BLVD",
            "address_2": "SUITE #101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234545876",
            "telephone_number": "757-430-0990",
            "fax_number": "757-430-6860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "SUSAN",
        "middle_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2558",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2234399",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.