Commonwealth Family Health Care

Primary specialty

Pediatric ChiropractorTaxonomy code 111NP0017X

License

0104001811 Issued in VA

Legal business name

COMMONWEALTH FAMILY HEALTH CARE

Practice address

5216 Rolling Rd
Burke, VA 22015-1639

Phone

(703) 323-8500

Fax

(703) 323-4176

NPI assigned

Apr 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. Mary Jo Palmer, DCNPI 1407991524

Title

Doctor Owner

Phone

(703) 323-8500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Jo Palmer, DC

  • Chiropractor
  • Burke, VA
  • NPI 1407991524

  DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1334448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334448000000",
    "number": "1710244728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5216 ROLLING RD",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220151639",
            "telephone_number": "703-323-8500",
            "fax_number": "703-323-4176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5216 ROLLING RD",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220151639",
            "telephone_number": "703-323-8500",
            "fax_number": "703-323-4176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH FAMILY HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-15",
        "last_updated": "2012-04-15",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "DOCTOR OWNER",
        "authorized_official_telephone_number": "703-323-8500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NP0017X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "VA",
            "license": "0104001811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Chiropractor in Burke, VA
• Providers in Burke, VA by specialty
• Pediatric Chiropractor in Virginia

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