NPIMap

Organization Active NPI

Chiro Physical Medicine, LLC

Doing business as Ballston Chiropractic and Acupuncture

  • Chiropractor
  • Arlington, VA
National Provider Identifier
1700027091
Registry record updated Mar 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104556660 Issued in VA
Legal business name
CHIRO PHYSICAL MEDICINE, LLC
Doing business as
Ballston Chiropractic and Acupuncture
Practice address
3801 Fairfax Dr Ste 12
Arlington, VA 22203-1762
Phone
(703) 243-7878
Fax
(703) 243-7880
NPI assigned
Mar 16, 2009
Last updated
Mar 16, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2009

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

Authorized official

Name
Dr. Sam Masri, D.C.
Title
Chiropractor
Phone
(708) 369-3002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104556660 VA Primary

Addresses

Primary practice location

3801 Fairfax Dr Ste 12
Arlington, VA 22203-1762

Mailing address

3801 Fairfax Dr Ste 12
Arlington, VA 22203-1762
Phone (703) 243-7878

Other names 1

  • Ballston Chiropractic and Acupuncture Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090504000080 DC Part B Supplier - Clinic/Group Practice 1052469939 Receives reassigned benefits from 2 practitioners
Practice locations: Arlington, VA

National Provider Directory

National Provider Directory
Tax ID family
Ballston Chiropractic Accupuncture2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3801 Fairfax Dr
Ste 12
Arlington, VA 22203
Phone (570) 350-7939

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237161600000",
    "number": "1700027091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 FAIRFAX DR STE 12",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222031762",
            "telephone_number": "703-243-7878",
            "fax_number": "703-243-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 FAIRFAX DR STE 12",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222031762",
            "telephone_number": "703-243-7878",
            "fax_number": "703-243-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIRO PHYSICAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-16",
        "last_updated": "2009-03-16",
        "status": "A",
        "authorized_official_last_name": "MASRI",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "708-369-3002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ballston Chiropractic and Acupuncture",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arlington, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2009; 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.