Williamsburg Neck and Back Center LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104556654 Issued in VA

Legal business name

WILLIAMSBURG NECK AND BACK CENTER LLC

Practice address

4808 Courthouse St
Williamsburg, VA 23188-2684

Phone

(757) 345-6562

Fax

(757) 345-6516

NPI assigned

Aug 15, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Daniel Roth, D.C.NPI 1598900573

Title

Doctor

Phone

(757) 345-6562

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daniel David Roth, D.C.

  • Chiropractor
  • Williamsburg, VA
  • NPI 1598900573
  Medicare reassignment NPD Authorized official
• Anna Rayno, DC

  • Chiropractor
  • Williamsburg, VA
  • NPI 1154189439
  Medicare reassignment NPD
• Brian D. Kellam

  • Massage Therapist
  • Williamsburg, VA
  • NPI 1225903354
  NPD
• Kamila McCaskill

  • Massage Therapist
  • Williamsburg, VA
  • NPI 1912873449

  Single Specialty

  NPD
• Jennifer Mishoe, LMT

  • Massage Therapist
  • Williamsburg, VA
  • NPI 1659246767
  NPD
• Kylie Pearce

  • Massage Therapist
  • Williamsburg, VA
  • NPI 1407721558
  NPD

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344988800000",
    "number": "1699023135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4808 COURTHOUSE ST",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231882684",
            "telephone_number": "757-345-6562",
            "fax_number": "757-345-6516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4808 COURTHOUSE ST",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231882684",
            "telephone_number": "757-345-6562",
            "fax_number": "757-345-6516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMSBURG NECK AND BACK CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-15",
        "last_updated": "2012-08-15",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "757-345-6562",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Williamsburg Inpatient Services LLC
• Williamsburg Landing Home Health, LLC (Williamsburg Landing Home Health)
• Williamsburg Landing Inc
• Williamsburg Landing Inc (Williamsburg Landing Clinic)
• Williamsburg Mobility LLC
• Williamsburg Neurology, P.C.
• Williamsburg Obstetrics & Gynecology
• Williamsburg Plastic Surgery PC
• Williamsburg Professional Services, Inc. (Williamsburg Professional Services)
• Williamsburg Psychiatric Medicine

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2012; 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.