Active NPI
Lisa Dawn Cuervo, DC
- Chiropractor
- Virginia Beach, VA
National Provider Identifier
1053465070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 0104001682
- Practice address
- 4652 Haygood Rd Ste C
Virginia Beach, VA 23455-5447 - Phone
- (757) 363-0118
- Fax
- (757) 363-8932
- NPI assigned
- Jan 23, 2007
- Sex
- Female
- 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 | 0104001682 | VA | Primary |
Addresses
Primary practice location
4652 Haygood Rd Ste C
Virginia Beach, VA 23455-5447
Mailing address
4652 Haygood Rd Ste C
Virginia Beach, VA 23455-5447
Phone (757) 363-0118
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 331206 | Other | VA | ANTHEM BCBS |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0104001682 | VA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1053465070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4652 HAYGOOD RD STE C",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234555447",
"telephone_number": "757-363-0118",
"fax_number": "757-363-8932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4652 HAYGOOD RD STE C",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234555447",
"telephone_number": "757-363-0118",
"fax_number": "757-363-8932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUERVO",
"first_name": "LISA",
"middle_name": "DAWN",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-23",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "VA",
"license": "0104001682",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "331206",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.