Organization Active NPI

West Chiropractic & Neuropathy Center LLC

  • Chiropractor
  • St Petersburg, FL
National Provider Identifier
1124518774
Registry record updated May 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH11834 Issued in FL
Legal business name
WEST CHIROPRACTIC & NEUROPATHY CENTER LLC
Practice address
7900 Dr Martin Luther King Jr St N
St Petersburg, FL 33702-4108
Phone
(727) 577-0004
NPI assigned
May 18, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2018

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

Authorized official

Name
Dr. Robert Marvenko, DC
Title
VP
Phone
(410) 456-5326

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH11834 FL Primary

Addresses

Primary practice location

7900 Dr Martin Luther King Jr St N
St Petersburg, FL 33702-4108

Mailing address

7900 Dr Martin Luther King Jr St N
St Petersburg, FL 33702-4108
Phone (727) 577-0004

Other names 1

  • Hip Knee & Neurpathy Centers Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251015002361 FL Part B Supplier - Clinic/Group Practice 2668723750 Receives reassigned benefits from 1 practitioner
Practice locations: St Petersburg, FL

National Provider Directory

National Provider Directory

Locations

7900 Dr Martin Luther King Jr St N
St Petersburg, FL 33702
Phone (410) 456-5326

8855 Martin Luther King St N
Ste 101
St Petersburg, FL 33702
Phone (727) 235-0435

8855 Dr Martin Luther King St N
St Petersburg, FL 33702
Phone (727) 577-0004

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1526601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526601600000",
    "number": "1124518774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 DR MARTIN LUTHER KING JR ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337024108",
            "telephone_number": "727-577-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 DR MARTIN LUTHER KING JR ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337024108",
            "telephone_number": "727-577-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST CHIROPRACTIC & NEUROPATHY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-18",
        "last_updated": "2018-05-18",
        "status": "A",
        "authorized_official_last_name": "MARVENKO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "410-456-5326",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH11834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hip Knee & Neurpathy Centers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hip Knee & Neurpathy Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2018; 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.