Justin J Passerini, D.C, M.S., R.D

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

0104-557369 Issued in VA

Practice address

1400 Roanoke Rd
Daleville, VA 24083-2935

Phone

(540) 992-6637

NPI assigned

Aug 18, 2016

Last updated

Oct 25, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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

• Botetourt Chiropractic

  • Chiropractor
  • Daleville, VA
  • NPI 1992985212
  NPD (past)

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

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1871048991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 342",
            "city": "DALEVILLE",
            "state": "VA",
            "postal_code": "240830342",
            "telephone_number": "540-992-6637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 ROANOKE RD",
            "city": "DALEVILLE",
            "state": "VA",
            "postal_code": "240832935",
            "telephone_number": "540-992-6637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASSERINI",
        "first_name": "JUSTIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C, M.S., R.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-18",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "VA",
            "license": "0104-557369",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "VA",
            "license": "0104-557369",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "GA",
            "license": "CHIR009634",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Onota Dialysis LLC (Daleville Dialysis)
• Optimal Function and Wellness, PLLC
• Kimberly R Orr
• Luisa Fernanda Oster
• Adam M Park, DDS
• Abby Hutchens Perry, RN
• Mary-Randall Garst Plunkett
• Rachael Marie Poff, PA-C
• Elizabeth Polk, MD
• Greg Leland Potter, D.O.

• Sports Physician Chiropractor in Daleville, VA
• Providers in Daleville, VA by specialty
• Sports Physician Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; 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.