Individual provider Active NPI

Bushra R Mahmud, DC

  • Chiropractor
  • Roanoke, VA
National Provider Identifier
1689339046
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104557755 Issued in VA
Practice address
4903 Starkey Rd Ste 100
Roanoke, VA 24018-8525
Phone
(540) 774-4443
NPI assigned
Nov 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104557755 VA Primary

Addresses

Primary practice location

4903 Starkey Rd Ste 100
Roanoke, VA 24018-8525

Mailing address

4903 Starkey Rd Ste 100
Roanoke, VA 24018-8525

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220120002021 VA Practitioner - Chiropractic 7517359714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tuck Chiropractic CorporationGroup PAC ID 0547222739, 10 clinicians

Practice addresses (Care Compare)

301 W Main St
Bedford, VA 24523-1902
Phone (540) 586-1105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104557755VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Tuck Chiropractic Corporation Chiropractor CurrentSince Jan 1, 2022 Accepting new patients
Tuck Chiropractic Corporation PastSince Dec 15, 2024 Accepting new patients

Locations

301 W Main St
Bedford, VA 24523
Phone (540) 586-1105

1901 S Main St
Ste 5
Blacksburg, VA 24060

620 N Main St
Ste 202
Blacksburg, VA 24060

1212 Corporate Cir SW
Ste 100
Roanoke, VA 24018

4903 Starkey Rd
Ste 100
Roanoke, VA 24018
Phone (540) 774-4443

1212 Corporate Cir SW
Roanoke, VA 24018
Phone (540) 776-8200

Organizations & group practices 2

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": "1635724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1689339046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4903 STARKEY RD STE 100",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240188525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4903 STARKEY RD STE 100",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240188525",
            "telephone_number": "540-774-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMUD",
        "first_name": "BUSHRA",
        "middle_name": "R",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-01",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104557755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; 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.