Individual provider Active NPI

Marc Fernandez Lampa, D.C.

  • Chiropractor
  • Dale City, VA
National Provider Identifier
1689772915
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104556442 Issued in VA
Practice address
2950 Dale Blvd
Dale City, VA 22193-1120
Phone
(703) 583-1222
Fax
(703) 583-1499
NPI assigned
Sep 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104556442 VA Primary

Addresses

Primary practice location

2950 Dale Blvd
Dale City, VA 22193-1120

Mailing address

15215 Illinois Rd
Woodbridge, VA 22191-3624
Phone (678) 571-7874

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211228001759 NJ Practitioner - Chiropractic 5294839056 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NJ Institute for Pain ReliefGroup PAC ID 0648622217, 11 clinicians

Practice addresses (Care Compare)

438 Commons Way
Building D
Toms River, NJ 08755-6428
Phone (732) 797-1771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104556442VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Physical Therapy and Rehab Center PC Chiropractor CurrentSince Sep 10, 2021 Accepting new patients
NJ Institute for Pain Relief Chiropractor CurrentSince Oct 27, 2025 Accepting new patients

Locations

305 Bayonne Crossing Way
Ste 101
Bayonne, NJ 07002
Phone (201) 778-2020

25 Commerce Dr
Ste 100
Cranford, NJ 07016
Phone (908) 801-0644

438 Commons Way
Bldg D
Toms River, NJ 08755
Phone (609) 601-2191

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689772915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15215 ILLINOIS RD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913624",
            "telephone_number": "678-571-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 DALE BLVD",
            "city": "DALE CITY",
            "state": "VA",
            "postal_code": "221931120",
            "telephone_number": "703-583-1222",
            "fax_number": "703-583-1499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMPA",
        "first_name": "MARC",
        "middle_name": "FERNANDEZ",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dale City, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.