Individual provider Active NPI

Michael Roy McConnell, D.C

  • Chiropractor
  • Norfolk, VA
National Provider Identifier
1700139821
Registry record updated Feb 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104557014 Issued in VA
Practice address
951 W 21St St
Norfolk, VA 23517-1534
Phone
(757) 623-0867
Fax
(757) 627-2923
NPI assigned
Oct 26, 2012
Last updated
Feb 14, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104557014 VA Primary

Addresses

Primary practice location

951 W 21St St
Norfolk, VA 23517-1534

Mailing address

951 W 21St St
Norfolk, VA 23517-1534
Phone (757) 623-0867

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140527000139 VA Practitioner - Chiropractic 7517180243 Practice locations: Norfolk, VA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104557014VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Esprit Health Incorporated, LLC PastSince Dec 21, 2021 Accepting new patients

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, 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": "1351209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518566400000",
    "number": "1700139821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 W 21ST ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235171534",
            "telephone_number": "757-623-0867",
            "fax_number": "757-627-2923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 W 21ST ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235171534",
            "telephone_number": "757-623-0867",
            "fax_number": "757-627-2923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNELL",
        "first_name": "MICHAEL",
        "middle_name": "ROY",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-26",
        "last_updated": "2018-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104557014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2018; 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.