Individual provider Active NPI

Kyle Steven Bloch, D.C.

  • Chiropractor
  • Manassas, VA
National Provider Identifier
1861779746
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104556936 Issued in VA
Practice address
8224 Spruce St Ste 330
Manassas, VA 20111-2201
Phone
(703) 368-8800
Fax
(703) 368-1281
NPI assigned
Nov 7, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104556936 VA Primary

Addresses

Primary practice location

8224 Spruce St Ste 330
Manassas, VA 20111-2201

Mailing address

8224 Spruce St
Ste 330
Manassas, VA 20111-2201
Phone (703) 368-8800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151209002739 VA Practitioner - Chiropractic 1557662939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8224 Spruce St
Suite 330
Manassas, VA 20111-2201
Phone (703) 368-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104556936VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
American Chiropractic Clinic, PLLC Chiropractor CurrentSince Oct 7, 2015 Accepting new patients

Locations

8424 Dorsey Cir
Ste 102
Manassas, VA 20110
Phone (703) 368-1715

8224 Spruce St
Ste 330
Manassas, VA 20111
Phone (703) 368-8000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1320624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1861779746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8224 SPRUCE ST",
            "address_2": "STE 330",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201112201",
            "telephone_number": "703-368-8800",
            "fax_number": "703-368-1281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8224 SPRUCE ST STE 330",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201112201",
            "telephone_number": "703-368-8800",
            "fax_number": "703-368-1281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCH",
        "first_name": "KYLE",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-07",
        "last_updated": "2022-07-21",
        "certification_date": "2022-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.