Vassil I Valov, DC
Individual provider Active NPI Chiropractor · St Johns, FL
NPI 1104856129 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1104856129
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- CH12184 (FL)
- Practice address
- 254 Everest LN
St Johns, FL 32259 - Phone
- (904) 862-2662
- Fax
- (904) 862-2662
- NPI assigned
- Jul 4, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- 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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171214000502 | FL | Practitioner - Chiropractic | 8123038460 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH12184 | FL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healx Care LLC | Chiropractor | Current |
Accepting new patients |
| Abundant Life Health Center LLC | Chiropractor | Current |
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CR1634 | ME | |
| Chiropractor | 111N00000X | CH12184 | FL | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 432191999 | Medicaid | ME | |
| 6034814 | Other | ME | CIGNA |
| 100338 | Other | ME | BC/BS |
Other providers in St Johns, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.