Organization Active NPI

Rocky Mount Chiropractic Inc

  • Chiropractor
  • Rocky Mount, VA
National Provider Identifier
1952455875
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104001373 Issued in VA
Legal business name
ROCKY MOUNT CHIROPRACTIC INC
Practice address
546 Pell Ave
Rocky Mount, VA 24151
Phone
(540) 483-7620
Fax
(540) 483-7739
NPI assigned
Jan 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Tina Faye Callaway
Title
Office Manager
Phone
(540) 483-7620

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 0104001373 VA Primary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 0104001574 VA

Addresses

Primary practice location

546 Pell Ave
Rocky Mount, VA 24151

Mailing address

546 Pell Ave
Rocky Mount, VA 24151
Phone (540) 483-7620

Other identifiers 4

IdentifierTypeStateIssuer
337526OtherVABCBS
7470475OtherAETNA
5900064OtherAETNA
260654OtherVABCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110121000393 VA Part B Supplier - Clinic/Group Practice 7416136536 Receives reassigned benefits from 2 practitioners
Practice locations: Rocky Mount, VA

National Provider Directory

National Provider Directory

Locations

546 Pell Ave
Rocky Mount, VA 24151
Phone (540) 483-7620

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952455875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 PELL AVE",
            "city": "ROCKY MOUNT",
            "state": "VA",
            "postal_code": "24151",
            "telephone_number": "540-483-7620",
            "fax_number": "540-483-7739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 PELL AVE",
            "city": "ROCKY MOUNT",
            "state": "VA",
            "postal_code": "24151",
            "telephone_number": "540-483-7620",
            "fax_number": "540-483-7739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY MOUNT CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CALLAWAY",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "FAYE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "540-483-7620"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104001373",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104001574",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "337526",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7470475",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5900064",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "260654",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.