Active NPI
Ilya Spivak, DC
- Chiropractor
- Miami Gardens, FL
National Provider Identifier
1013488774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH12573
- Practice address
- 17560 NW 27TH Ave Ste 117
Miami Gardens, FL 33056-4075 - Phone
- (305) 623-5939
- NPI assigned
- Dec 6, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH12573 | FL | Primary |
Addresses
Primary practice location
17560 NW 27TH Ave Ste 117
Miami Gardens, FL 33056-4075
Mailing address
1580 Shoreline Way
Hollywood, FL 33019-5010
Phone (954) 589-8374
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544054400000",
"number": "1013488774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1580 SHORELINE WAY",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330195010",
"telephone_number": "954-589-8374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17560 NW 27TH AVE STE 117",
"city": "MIAMI GARDENS",
"state": "FL",
"postal_code": "330564075",
"telephone_number": "305-623-5939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPIVAK",
"first_name": "ILYA",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-12-06",
"last_updated": "2018-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH12573",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.