Individual provider Active NPI

Vassil I Valov, DC

  • Chiropractor
  • Saint Johns, FL
National Provider Identifier
1104856129
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH12184 Issued in FL
Practice address
254 Everest LN
St Johns, FL 32259
Phone
(904) 862-2662
Fax
(904) 862-2662
NPI assigned
Jul 4, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CR1634 ME
Chiropractor 111N00000X CH12184 FL Primary

Addresses

Primary practice location

254 Everest LN
St Johns, FL 32259

Mailing address

56 Canary Palm CT
Ponte Vedra, FL 32081-6100
Phone (716) 308-5283

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171214000502 FL Practitioner - Chiropractic 8123038460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2006
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

254 Everest LN
Suite 2
St Johns, FL 32259-4107
Phone (904) 862-2662

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH12184FLMDChiropractor
CR1634MEMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Abundant Life Health Center LLC Chiropractor CurrentSince Jan 4, 2016 Accepting new patients
Healx Care LLC Chiropractor CurrentSince Jul 22, 2025 Accepting new patients

Locations

254 Everest Ln
St Johns, FL 32259
Phone (904) 862-2662

254 Everest Ln
Ste 2
St Johns, FL 32259
Phone (716) 308-5283

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1104856129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 CANARY PALM CT",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320816100",
            "telephone_number": "716-308-5283",
            "fax_number": "904-862-2662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 EVEREST LN",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "32259",
            "telephone_number": "904-862-2662",
            "fax_number": "904-862-2662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALOV",
        "first_name": "VASSIL",
        "middle_name": "I",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ME",
            "license": "CR1634",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Johns, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.