Individual provider Active NPI

Dorothy A. Fensterer, D.C.

  • Chiropractor
  • South Boston, VA
National Provider Identifier
1881672467
Registry record updated Feb 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104001067 Issued in VA
Practice address
1993 Hamilton Blvd
Suite a
South Boston, VA 24592-2146
Phone
(434) 575-5130
Fax
(434) 575-7570
NPI assigned
Jan 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104001067 VA Primary

Addresses

Primary practice location

1993 Hamilton Blvd
Suite a
South Boston, VA 24592-2146

Mailing address

1993 Hamilton Blvd
Suite a
South Boston, VA 24592-2146
Phone (434) 575-5130

Other identifiers 2

IdentifierTypeStateIssuer
89-1404-4MedicaidVA
251748OtherVAANTHEM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081020000127 VA Practitioner - Chiropractic 7618035767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Degraw Chiropractic Center IncGroup PAC ID 3375737125, 3 clinicians

Practice addresses (Care Compare)

1993 Hamilton Blvd
Suite a
South Boston, VA 24592-2146
Phone (434) 575-5130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104001067VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Degraw Chiropractic Center, Inc Chiropractor CurrentSince Apr 3, 2011 Accepting new patients

Locations

1993 Hamilton Blvd
Ste A
South Boston, VA 24592
Phone (434) 575-5130

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": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297900800000",
    "number": "1881672467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1993 HAMILTON BLVD",
            "address_2": "SUITE A",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245922146",
            "telephone_number": "434-575-5130",
            "fax_number": "434-575-7570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1993 HAMILTON BLVD",
            "address_2": "SUITE A",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245922146",
            "telephone_number": "434-575-5130",
            "fax_number": "434-575-7570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENSTERER",
        "first_name": "DOROTHY",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-04",
        "last_updated": "2011-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104001067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89-1404-4",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "251748",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Boston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2011; 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.