Individual provider Active NPI

Robert L McClure, D.C.

  • Chiropractor
  • Dale City, VA
National Provider Identifier
1902963366
Registry record updated Oct 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104556493 Issued in VA
Practice address
2950 Dale Blvd
Dale City, VA 22193-1120
Phone
(202) 362-0900
Fax
(202) 362-1391
NPI assigned
Jan 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104556493 VA Primary
Rehabilitation Chiropractor 111NR0400X CH030069 DC

Addresses

Primary practice location

2950 Dale Blvd
Dale City, VA 22193-1120

Mailing address

5100 Wisconsin Ave NW
Suite 251
Washington, DC 20016-4119
Phone (202) 362-0900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080215000188 DC Practitioner - Chiropractic 0648237016 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104556493VAMDChiropractor
CH030069DCMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Life Chiropractic of Olney, LLC Rehabilitation CurrentSince Jan 1, 2026 Accepting new patients
Thomas M Connelly LLC Chiropractor PastSince Mar 22, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Life Chiropractic of Olney Chiropractor PastSince Jan 1, 2026 Accepting new patients

Locations

18120 Hillcrest Ave
Ste D
Olney, MD 20832
Phone (301) 924-6444

Organizations & group practices 4

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191542400000",
    "number": "1902963366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 WISCONSIN AVE NW",
            "address_2": "SUITE 251",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200164119",
            "telephone_number": "202-362-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 DALE BLVD",
            "city": "DALE CITY",
            "state": "VA",
            "postal_code": "221931120",
            "telephone_number": "202-362-0900",
            "fax_number": "202-362-1391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLURE",
        "first_name": "ROBERT",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556493",
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "DC",
            "license": "CH030069",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dale City, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; 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.