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SIOBHAN A CONKLYN DC PC
Complete NPI Record 1467684753
Chiropractor in Hayes, VA

NPI Status: Active since August 20, 2009

Contact Information

2654 GEORGE WASHINGTON MEMORIAL HWY
SUITE2
HAYES, VA
ZIP 23072
Phone: (804) 642-6106

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider First Line Business Practice Location Address
  11. Provider Second Line Business Practice Location Address
  12. Provider Business Practice Location Address City Name
  13. Provider Business Practice Location Address State Name
  14. Provider Business Practice Location Address Postal Code
  15. Provider Business Practice Location Address Country Code If outside U S
  16. Provider Business Practice Location Address Telephone Number
  17. Provider Enumeration Date
  18. Last Update Date
  19. Authorized Official Last Name
  20. Authorized Official First Name
  21. Authorized Official Middle Name
  22. Authorized Official Title or Position
  23. Authorized Official Telephone Number
  24. Healthcare Provider Taxonomy Code 1
  25. Provider License Number 1
  26. Provider License Number State Code 1
  27. Healthcare Provider Primary Taxonomy Switch 1
  28. Is Organization Subpart
  29. Authorized Official Credential Text
  30. Healthcare Provider Taxonomy Group 1

Complete NPI Dataset

This page represents the complete record for NPI 1467684753. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1467684753
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Entity Type Code: 2
The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider First Line Business Mailing Address: 3777 BRIGGS COVE RD
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: HAYES
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: VA
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Postal Code: 230722617
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Country Code If outside U S : US
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider First Line Business Practice Location Address: 2654 GEORGE WASHINGTON MEMORIAL HWY
The city name in the location address of the provider being identified.
Provider Second Line Business Practice Location Address: SUITE2
The State code in the location of the provider being identified.
Provider Business Practice Location Address City Name: HAYES
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address State Name: VA
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code: 230723464
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Country Code If outside U S : US
The date the provider was assigned a unique identifier (assigned an NPI).
Provider Business Practice Location Address Telephone Number: 8046426106
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 8/20/2009
The date that a record was last updated or changed.
Last Update Date: 8/20/2009
The date that a record was last updated or changed.
Authorized Official Last Name: ABBOTT
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: SIOBHAN
The second line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider second line location address’’.
Authorized Official Middle Name: AC
The middle name of the authorized official.
Authorized Official Title or Position: OWNER
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Authorized Official Telephone Number: 7578143581
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 111N00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 0104556420
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: VA
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Organization Subpart: N
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
Authorized Official Credential Text: DC
Healthcare Provider Taxonomy Group 1: 193400000X SINGLE SPECIALTY GROUP