Talleree Nichole Joebgen, D.C.
Individual provider Active NPI Chiropractor · Great Falls, VA
NPI 1730299223 · NPPES record last updated Mar 31, 2008
Key facts
- NPI
- 1730299223
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 0104555841 (VA)
- Practice address
- 754 Walker Rd
Great Falls, VA 22066-2654 - Phone
- (703) 757-5817
- Fax
- (703) 757-5478
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081014000619 | DC | Practitioner - Chiropractic | 5991873275 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0104555841 | VA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Virginia Joint and Spine Center PC | Chiropractor | Current |
Accepting new patients |
| Loebig Chiropractic, P.C. | Chiropractor | Past | Accepting new patients |
Locations
754 Walker Rd
Great Falls, VA 22066
Phone (703) 757-5817
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 0104555841 | VA | Yes |
Addresses
Primary practice location
754 Walker Rd
Great Falls, VA 22066-2654
Mailing address
754 Walker Rd
Great Falls, VA 22066-2654
Phone (703) 757-5817
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 167445 | Other | VA | BLUECROSS BLUE SHIELD |
Other providers in Great Falls, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 31, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.