Nicholas Divan, D.C.

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

2014010441 Issued in MO

Practice address

8045 Big Bend Blvd Ste 107
Saint Louis, MO 63119-2714

Phone

(314) 961-7181

NPI assigned

Mar 6, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1394064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1114343704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8045 BIG BEND BLVD STE 107",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631192714",
            "telephone_number": "314-961-7181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8045 BIG BEND BLVD STE 107",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631192714",
            "telephone_number": "314-961-7181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23331 Via Venado",
            "address_purpose": "LOCATION",
            "city": "Coto DE Caza",
            "state": "CA",
            "postal_code": "926793905",
            "country_code": "US",
            "telephone_number": "949-632-3477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIVAN",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "MO",
            "license": "2014010441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larina Jolynn Ditto, MSW
• Nicole Niara Ditto
• Vijayalakshmi Divakaran, ARNP, BC
• Richard M Divalerio, M.D.
• Divan Chiropractic and Sports Rehabilitation
• Taraneh Maryam Divanbeigi, FNP-C
• Chirag Divecha, MD
• Diverse Health Services LLC
• Diverse Ventures, LLC
• Diversified Home Care LLC

• Rehabilitation Chiropractor in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Rehabilitation Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.

Verify at the official NPI Registry.