Healthcare Provider Details

I. General information

NPI: 1245391226
Provider Name (Legal Business Name): JEREMY WADE SCHMIDT DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6940-A BRADDOCK RD.
ANNANDALE VA
22033
US

IV. Provider business mailing address

1201 N GARFIELD ST 601
ARLINGTON VA
22201-6800
US

V. Phone/Fax

Practice location:
  • Phone: 703-333-5022
  • Fax: 703-333-5023
Mailing address:
  • Phone: 703-888-0880
  • Fax: 703-333-5023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104556483
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number0104556483
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: