Individual provider Active NPI

Elizabeth Tolly Shearin, DC

  • Chiropractor
  • Suffolk, VA
National Provider Identifier
1700980133
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104001887 Issued in VA
Practice address
2469 Pruden Blvd
Suffolk, VA 23434
Phone
(757) 539-4100
Fax
(757) 539-9187
NPI assigned
Sep 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 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 0104001887 VA Primary

Addresses

Primary practice location

2469 Pruden Blvd
Suffolk, VA 23434

Mailing address

111 W VA Beach Blvd
Norfolk, VA 23510-2005
Phone (757) 623-7776

Other names 1

  • Elizabeth Anne Tolly Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120130000391 VA Practitioner - Chiropractic 3870750128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2469 Pruden Blvd
Suffolk, VA 23434-4235
Phone (757) 539-4100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shearin Chiropractic LLC Chiropractor CurrentSince Apr 24, 2021 Accepting new patients
Walter Chiropractic Clinic Chiropractor Current Accepting new patients

Locations

2469 Pruden Blvd
Suffolk, VA 23434
Phone (757) 539-4100

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1700980133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W VA BEACH BLVD",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235102005",
            "telephone_number": "757-623-7776",
            "fax_number": "757-623-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2469 PRUDEN BLVD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "23434",
            "telephone_number": "757-539-4100",
            "fax_number": "757-539-9187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEARIN",
        "first_name": "ELIZABETH",
        "middle_name": "TOLLY",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104001887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "TOLLY",
            "middle_name": "ANNE",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Suffolk, VA

Sources for this page

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