Individual provider Active NPI

Robert Wayne Kovacs, D.C.

  • Chiropractor
  • Gilroy, CA
National Provider Identifier
1063436053
Registry record updated Mar 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
17234 Issued in CA
Practice address
7888 Wren Ave
Suite B123
Gilroy, CA 95020-4962
Phone
(408) 848-3666
Fax
(408) 848-3667
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 17234 CA Primary

Addresses

Primary practice location

7888 Wren Ave
Suite B123
Gilroy, CA 95020-4962

Mailing address

7888 Wren Ave
Suite B123
Gilroy, CA 95020-4962
Phone (408) 848-3666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100722000198 CA Practitioner - Chiropractic 7214069590 Practice locations: Gilroy, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gilroy Chiropractic Center Chiropractor Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268006400000",
    "number": "1063436053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7888 WREN AVE",
            "address_2": "SUITE B123",
            "city": "GILROY",
            "state": "CA",
            "postal_code": "950204962",
            "telephone_number": "408-848-3666",
            "fax_number": "408-848-3667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7888 WREN AVE",
            "address_2": "SUITE B123",
            "city": "GILROY",
            "state": "CA",
            "postal_code": "950204962",
            "telephone_number": "408-848-3666",
            "fax_number": "408-848-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVACS",
        "first_name": "ROBERT",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2010-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "17234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilroy, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.