NPIMap

Organization Active NPI

Bea, LLC

  • Chiropractor
  • Fredericksburg, VA
National Provider Identifier
1831483734
Registry record updated Jun 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104555602 Issued in VA
Legal business name
BEA, LLC
Practice address
5705 Salem Run Blvd
Suite 100
Fredericksburg, VA 22407-7119
Phone
(540) 786-4882
Fax
(540) 786-4893
NPI assigned
Jun 8, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2011

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

Authorized official

Name
Steven F Shields
Title
Billing Manager
Phone
(804) 282-9133

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 0104555602 VA Primary

Addresses

Primary practice location

5705 Salem Run Blvd
Suite 100
Fredericksburg, VA 22407-7119

Mailing address

5705 Salem Run Blvd
Suite 100
Fredericksburg, VA 22407-7119
Phone (540) 786-4882

Other identifiers 1

IdentifierTypeStateIssuer
0104555602OtherVAVIRGINIA MEDICAL LICENSE NUMBER

Other names 1

  • TOTAL HEALTH CHIROPRACTIC CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110907000881 VA Part B Supplier - Clinic/Group Practice 1951571686 Receives reassigned benefits from 1 practitioner
Practice locations: Fredericksburg, VA

National Provider Directory

National Provider Directory

Locations

12200 Amos Ln
Fredericksburg, VA 22407
Phone (540) 786-4882

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1307491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307491200000",
    "number": "1831483734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5705 SALEM RUN BLVD",
            "address_2": "SUITE 100",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224077119",
            "telephone_number": "540-786-4882",
            "fax_number": "540-786-4893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5705 SALEM RUN BLVD",
            "address_2": "SUITE 100",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224077119",
            "telephone_number": "540-786-4882",
            "fax_number": "540-786-4893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-08",
        "last_updated": "2011-06-08",
        "status": "A",
        "authorized_official_last_name": "SHIELDS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "804-282-9133"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104555602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA MEDICAL LICENSE NUMBER",
            "identifier": "0104555602",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TOTAL HEALTH CHIROPRACTIC CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; 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.