CORE PAIN & WELLNESS CENTER LLC
NPI 1417620659
Chiropractor in Fairfax, VA
About Core Pain & Wellness Center Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CORE PAIN & WELLNESS CENTER LLC (NPI 1417620659) is a healthcare organization registered as a chiropractor in Fairfax, Virginia and active in the NPI registry since July 2021. The organization lists Peter Taejoo Jeong, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Core Pain & Wellness Center Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Core Pain & Wellness Center LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Core Pain & Wellness Center LLC's NPI number?
The NPI number for Core Pain & Wellness Center LLC is 1417620659. It was assigned to this organization in the NPPES registry on July 25, 2021.
Where is Core Pain & Wellness Center LLC located?
Core Pain & Wellness Center LLC is located at 10721 Main St Ste G7, Fairfax, VA 22030. The listed phone number is (703) 814-6650.
What is Core Pain & Wellness Center LLC's specialty?
The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.
Is Core Pain & Wellness Center LLC enrolled in Medicare?
Yes. Core Pain & Wellness Center LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Core Pain & Wellness Center LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Core Pain & Wellness Center LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Core Pain & Wellness Center LLC was last updated on July 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Core Pain & Wellness Center Llc · NPI 1417620659
Chiropractor organization in Fairfax, Virginia. Organization record, active in the CMS NPPES registry since July 25, 2021.
## Identity
- **NPI:** 1417620659 (Entity type: Organization)
- **Enumerated:** July 25, 2021
- **Primary specialty:** Chiropractor · taxonomy 111N00000X
- **Organization subpart:** No
- **Authorized official:** Peter Jeong, PRESIDENT
## Practice location
- **Address:** 10721 MAIN ST STE G7, Fairfax, VA 22030-6913
- **Phone:** (703) 814-6650
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Chiropractic) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 25, 2021
---
Source: [NPI Profile](https://npiprofile.com/npi/1417620659) · Data from the CMS NPPES public registry.