Family Chiropractic Center of Lake Ridge

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104000798 Issued in VA

Legal business name

FAMILY CHIROPRACTIC CENTER OF LAKE RIDGE

Practice address

12801 Darby Brook CT Ste 102
Woodbridge, VA 22192-2497

Phone

(703) 497-2020

Fax

(703) 492-6105

NPI assigned

Dec 11, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Ross Weinberg, D.C.

Title

Doctor President

Phone

(703) 497-2020

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713484800000",
    "number": "1932269057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12801 DARBY BROOK CT STE 102",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922497",
            "telephone_number": "703-497-2020",
            "fax_number": "703-492-6105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12801 DARBY BROOK CT STE 102",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922497",
            "telephone_number": "703-497-2020",
            "fax_number": "703-492-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CHIROPRACTIC CENTER OF LAKE RIDGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "ROSS",
        "authorized_official_title_or_position": "DOCTOR PRESIDENT",
        "authorized_official_telephone_number": "703-497-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104000798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDIPA, MAMSI",
            "identifier": "215560",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPPO",
            "identifier": "504133",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HEALTHCARE",
            "identifier": "1023916",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCAS",
            "identifier": "75190",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "231686",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9430604001",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "S398-001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; 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.