NPIMap

Organization Active NPI

Pro-Perform Spinal Health & Rehab LLC

  • Chiropractor
  • Waldorf, MD
National Provider Identifier
1851791735
Registry record updated Aug 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S03581 Issued in MD
Legal business name
PRO-PERFORM SPINAL HEALTH & REHAB LLC
Practice address
12070 Old Line Ctr
Suite 301
Waldorf, MD 20602-2513
Phone
(301) 705-7800
NPI assigned
Aug 28, 2014
Last updated
Aug 28, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2014

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

Authorized official

Name
Everett N Scott, D.C.
Title
President
Phone
(301) 705-7800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X S03581 MD Primary

Addresses

Primary practice location

12070 Old Line Ctr
Suite 301
Waldorf, MD 20602-2513

Mailing address

12070 Old Line Ctr
Suite 301
Waldorf, MD 20602-2513
Phone (301) 705-7800

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1409184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409184000000",
    "number": "1851791735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12070 OLD LINE CTR",
            "address_2": "SUITE 301",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022513",
            "telephone_number": "301-705-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12070 OLD LINE CTR",
            "address_2": "SUITE 301",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022513",
            "telephone_number": "301-705-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO-PERFORM SPINAL HEALTH & REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-28",
        "last_updated": "2014-08-28",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "EVERETT",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-705-7800",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S03581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.