Individual provider Active NPI

Michael Anthony Spagnolo, D.C.

  • Chiropractor
  • Glen Allen, VA
National Provider Identifier
1942209556
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104001916 Issued in VA
Practice address
11535 Nuckols Rd
Ste. D
Glen Allen, VA 23059-5671
Phone
(804) 747-5464
Fax
(804) 747-5483
NPI assigned
Jul 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104001916 VA Primary

Addresses

Primary practice location

11535 Nuckols Rd
Ste. D
Glen Allen, VA 23059-5671

Mailing address

11535 Nuckols Rd
Ste. D
Glen Allen, VA 23059-5671
Phone (804) 747-5464

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041018000084 VA Practitioner - Chiropractic 6204896095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11535 Nuckols Rd
Suite D
Glen Allen, VA 23059-5671
Phone (804) 747-5464

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104001916VAMDChiropractor
5375GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Glen Allen Chiropractic & Acupuncture Center PC Chiropractor CurrentSince Apr 30, 2004 Accepting new patients

Locations

11535 Nuckols Rd
Ste D
Glen Allen, VA 23059
Phone (804) 747-5464

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": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1942209556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11535 NUCKOLS RD",
            "address_2": "STE. D",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595671",
            "telephone_number": "804-747-5464",
            "fax_number": "804-747-5483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11535 NUCKOLS RD",
            "address_2": "STE. D",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595671",
            "telephone_number": "804-747-5464",
            "fax_number": "804-747-5483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAGNOLO",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104001916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Allen, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.