Hickory Chiropractic and Sports Rehabilitation Center PLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104556563 Issued in VA

Legal business name

HICKORY CHIROPRACTIC AND SPORTS REHABILITATION CENTER PLC

Doing business as

Hickory Chiro and Sports Rehab
Hickory Chiropractic

Practice address

109 Wimbledon SQ Ste D
Chesapeake, VA 23320-4945

Phone

(757) 410-9550

Fax

(757) 410-9506

NPI assigned

Oct 31, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Virginia Ellen Petree, D.C.NPI 1720267297

Title

Owner

Phone

(757) 410-9550

Specialties & licenses 1

Addresses

Other names 2

• Hickory Chiro and Sports Rehab Doing business as
• Hickory Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 2

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

• Virginia Ellen Petree, D.C.

  • Chiropractor
  • Chesapeake, VA
  • NPI 1720267297
  Medicare reassignment Authorized official
• Colin Wade Eastwood, D.C.

  • Chiropractor
  • Chesapeake, VA
  • NPI 1326220831
  Medicare reassignment NPD

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718755200000",
    "number": "1982883450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 WIMBLEDON SQ STE D",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204945",
            "telephone_number": "757-410-9550",
            "fax_number": "757-410-9506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 WIMBLEDON SQ STE D",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204945",
            "telephone_number": "757-410-9550",
            "fax_number": "757-410-9506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HICKORY CHIROPRACTIC AND SPORTS REHABILITATION CENTER PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A",
        "authorized_official_last_name": "PETREE",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-410-9550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hickory Chiro and Sports Rehab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hickory Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ameerah Kamilah-Theresa Herron
• Grant William Hessberger, PT, DPT
• Kevin M. Hesse, P.T.
• David Michael Hester, C.S.A.
• Amanda Sheree Hetrick, BA, RBT
• Tyneka Hicks
• Kari Higginbotham
• Christine D Higgins, MD
• Kelly Lynn Higgins, HIS
• Michelle Lynn Higgins, PT

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

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