Individual provider Active NPI

Lynn R Canzano, DC

  • Chiropractor
  • Herndon, VA
National Provider Identifier
1942366372
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104001467 Issued in VA
Practice address
423 Carlisle Dr
Herndon, VA 20170-4802
Phone
(703) 481-6004
Fax
(703) 481-8944
NPI assigned
Dec 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104001467 VA Primary

Addresses

Primary practice location

423 Carlisle Dr
Herndon, VA 20170-4802

Mailing address

423 Carlisle Dr
Herndon, VA 20170-4802
Phone (703) 481-6004

Other identifiers 3

IdentifierTypeStateIssuer
453264OtherVAANTHEM BCBS
7378225OtherVAAETNA
7264991OtherVACIGNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111208000076 DC Practitioner - Chiropractic 6800980871 Reassigns benefits to 1 organization

Care Compare profile

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

Practice addresses (Care Compare)

423 Carlisle Dr
Herndon, VA 20170-4802
Phone (703) 481-6004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Canzano Chiropractic & Wellness Center Chiropractor CurrentSince May 1, 2002 Accepting new patients

Locations

423 Carlisle Dr
Herndon, VA 20170
Phone (703) 481-6004

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": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942366372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 CARLISLE DR",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704802",
            "telephone_number": "703-481-6004",
            "fax_number": "703-481-8944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 CARLISLE DR",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704802",
            "telephone_number": "703-481-6004",
            "fax_number": "703-481-8944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANZANO",
        "first_name": "LYNN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104001467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "453264",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7378225",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7264991",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Herndon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.