Unknown Individual – Nutrition Chiropractor, NPI 1336162163

Unknown Individual is a healthcare provider. based in Annandale, Virginia. specializing in Nutrition Chiropractor. They hold a License No. 0104556829 (VA). The NPI Number for Unknown Individual is 1336162163

Main info

Organization
Inactive
29 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1336162163
Phone
(434) 422-0037
Address
4916 BRISTOW DR
Deactivation Date
24 April 2025

Doctor Profile

Medical School Name
CLEVELAND CHIROPRACTIC COLLEGE - KANSAS CITY
Secondary Phone
7037300200
Graduation Year
1997 (29 years ago)
PAC ID
8921019613
Group Practice PAC ID
2466640925
Professional Enrollment ID
I20110314000185
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 4916, Bristow Drive, Ravensworth Park, Annandale, Fairfax County, Virginia, 22003, United States

    ANNANDALE, VA 220035456

    Phone: (434) 422-0037

    Fax: (888) 398-9722

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 22003)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2466640925View full group profile
NameSpecialtyState
-VA

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1336162163?
NPI 1336162163 belongs to Unknown Individual; compare other details if you need extra assurance.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Nutrition Chiropractor. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Annandale, Virginia as the reference point for Unknown Individual, then confirm.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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