Spinal Source Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104-557380 Issued in VA

Legal business name

SPINAL SOURCE CHIROPRACTIC LLC

Practice address

6546 Hampton Roads Pkwy
Suite 112
Suffolk, VA 23435-3185

Phone

(757) 642-4945

Fax

(757) 977-1039

NPI assigned

Jan 28, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Taylor Bollig, D.C.

Title

Owner/Chiropractor

Phone

(757) 642-4945

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chase Bollig, D.C.

  • Chiropractor
  • Suffolk, VA
  • NPI 1801216304
  Medicare reassignment Care Compare group NPD
• Haley Cole, D.C.

  • Chiropractor
  • Virginia Beach, VA
  • NPI 1982477535
  Medicare reassignment Care Compare group NPD
• Adam Nathaniel Gold, D.C.

  • Chiropractor
  • Newport News, VA
  • NPI 1851550206
  Medicare reassignment Care Compare group NPD
• Annderria Winston, LMT

  • Massage Therapist
  • Suffolk, VA
  • NPI 1780571943
  NPD

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

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493856000000",
    "number": "1982061487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6546 HAMPTON ROADS PKWY",
            "address_2": "STE 112",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353185",
            "telephone_number": "757-296-2225",
            "fax_number": "757-977-1039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6546 HAMPTON ROADS PKWY",
            "address_2": "SUITE 112",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353185",
            "telephone_number": "757-642-4945",
            "fax_number": "757-977-1039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINAL SOURCE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-28",
        "last_updated": "2017-05-04",
        "status": "A",
        "authorized_official_last_name": "BOLLIG",
        "authorized_official_first_name": "TAYLOR",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "757-642-4945",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "11751",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "11140",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104-557380",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104-557378",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Huland Spain, PH. D.
• Rebecca Bobbitt Spalding, RPH
• Specialized Education of Virginia, Inc
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• Briana K Spellman, LPC
• Sport Medicine and Orthopaedic Center Inc
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• John David Spring, PA-C
• Michele Elizabeth Sprosty, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; 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.