Individual provider Active NPI

Jeffrey Kenneth Foddrell, DC

  • Chiropractor
  • North Chesterfield, VA
National Provider Identifier
1679577332
Registry record updated Feb 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104001922 Issued in VA
Practice address
1570 Early Settlers Rd
North Chesterfield, VA 23235-4458
Phone
(804) 330-9830
Fax
(804) 421-0869
NPI assigned
Jun 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104001922 VA Primary

Addresses

Primary practice location

1570 Early Settlers Rd
North Chesterfield, VA 23235-4458

Mailing address

1570 Early Settlers Rd
North Chesterfield, VA 23235-4458
Phone (804) 330-9830

Other identifiers 1

IdentifierTypeStateIssuer
114440OtherVAANTHEM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110608000021 VA Practitioner - Chiropractic 0446437016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1570 Early Settlers Rd
North Chesterfield, VA 23235-4458
Phone (804) 330-9830

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104001922VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Better Bodies Chiropractic, P. C. Chiropractor CurrentSince Apr 24, 2008 Accepting new patients

Locations

1570 Early Settlers Rd
North Chesterfield, VA 23235
Phone (804) 330-9830

8710 Choctaw Rd
Ste E4
North Chesterfield, VA 23235
Phone (804) 330-7830

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": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424390400000",
    "number": "1679577332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1570 EARLY SETTLERS RD",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232354458",
            "telephone_number": "804-330-9830",
            "fax_number": "804-421-0869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1570 EARLY SETTLERS RD",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232354458",
            "telephone_number": "804-330-9830",
            "fax_number": "804-421-0869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FODDRELL",
        "first_name": "JEFFREY",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2015-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104001922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "114440",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chesterfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2015; 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.