Balanced Life Chiropractic LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

BALANCED LIFE CHIROPRACTIC LLC

Practice address

9028 Prince William St Ste 2a
Manassas, VA 20110-5664

Phone

(703) 334-8597

NPI assigned

Nov 21, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Jacqueline Merced Gonzalez, DCNPI 1386041614

Title

Owner/Chiropractor

Phone

(404) 409-9010

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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.

• Jacqueline Merced Gonzalez, DC

  • Chiropractor
  • Manassas, VA
  • NPI 1386041614
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1542758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542758400000",
    "number": "1821567652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9028 PRINCE WILLIAM ST STE 2A",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201105664",
            "telephone_number": "703-334-8597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9028 PRINCE WILLIAM ST STE 2A",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201105664",
            "telephone_number": "703-334-8597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCED LIFE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-21",
        "last_updated": "2018-11-21",
        "status": "A",
        "authorized_official_last_name": "MERCED GONZALEZ",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "404-409-9010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wayne Thomas Bailey, M.D.
• Thomas Bajnok, MD
• Kristen Joanna Bakelaar
• Nadia Baker, PHARMD
• Yasmine Baker
• Nicholas Daniel Balbuena
• Stephen Robert Band, PH.D.
• Samuel Bangura
• Eman Bani, MD
• David C Banner, LPC, LMFT

• Primary Care Clinic/Center in Manassas, VA
• Providers in Manassas, VA by specialty
• Primary Care Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.