Loudoun Spine & Sports Group – Sports Physician Chiropractor, NPI 1104082064

Loudoun Spine & Sports Group is a healthcare provider. based in Ashburn, Virginia. specializing in Sports Physician Chiropractor. The organization holds a License No. 0104001181 (VA). The NPI Number for Loudoun Spine & Sports Group is 1104082064

Main info

Organization
Name
Loudoun Spine & Sports Group
NPI
1104082064
Phone
(703) 777-1234
Address
44121 HARRY BYRD HWY
Authorized Official
SHANDON J THOMPSON PRESIDENT D.C.
Enumeration Date
31 July 2008
Last Update Date
17 August 2010
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness80
Years active:17State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Loudoun Spine & Sports Group

  • 44121, Harry Byrd Highway, Ashburn, Loudoun County, Virginia, 20147, United States

    #120

    ASHBURN, VA 201475667

    Phone: (703) 777-1234

    Fax: (571) 918-0760

    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.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-03-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20040303000613OClinic/Group PracticeVATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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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 20147)

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Reviews

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Frequently asked questions

Can I verify Loudoun Spine & Sports Group with an NPI only?
You can start verification with NPI 1104082064 for Loudoun Spine & Sports Group, then check state licensing separately.
Can I rely on Loudoun Spine & Sports Group being an active provider?
As of the registry snapshot, Loudoun Spine & Sports Group is marked active.
What is Loudoun Spine & Sports Group's primary classification?
Sports Physician Chiropractor is the headline specialty for Loudoun Spine & Sports Group here. Clinical services aligned with this taxonomy classification.
Where is Loudoun Spine & Sports Group based?
Loudoun Spine & Sports Group is tied to Ashburn, Virginia in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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