Organization Active NPI

Chiropractic Neurology Enhancement Center

  • Neurology Chiropractor
  • Santa Rosa, CA
National Provider Identifier
1184029308
Registry record updated Jan 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
DC#26964 Issued in CA
Legal business name
CHIROPRACTIC NEUROLOGY ENHANCEMENT CENTER
Practice address
95 Montgomery Dr
Suite 118
Santa Rosa, CA 95404-6630
Phone
(707) 228-8405
NPI assigned
Oct 30, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2015

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

Authorized official

Name
Dr. Marjan Kaveh, DC , DACNBNPI 1740455492
Title
Chiropractor and Functional Neurolo
Phone
(707) 228-8405

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NN0400X DC#26964 CA Primary

Addresses

Primary practice location

95 Montgomery Dr
Suite 118
Santa Rosa, CA 95404-6630

Mailing address

95 Montgomery Dr
Suite 118
Santa Rosa, CA 95404-6630
Phone (707) 228-8405

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200603001322 FL Part B Supplier - Clinic/Group Practice 6800217696 Receives reassigned benefits from 1 practitioner
Practice locations: Boca Raton, FL

National Provider Directory

National Provider Directory

Locations

95 Montgomery Dr
Ste 118
Santa Rosa, CA 95404
Phone (707) 228-8405

Practitioners & affiliated clinicians

Practitioners 1

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": "1414627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420675200000",
    "number": "1184029308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 MONTGOMERY DR",
            "address_2": "SUITE 118",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954046630",
            "telephone_number": "707-228-8405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 MONTGOMERY DR",
            "address_2": "SUITE 118",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954046630",
            "telephone_number": "707-228-8405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC NEUROLOGY ENHANCEMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-30",
        "last_updated": "2015-01-08",
        "status": "A",
        "authorized_official_last_name": "KAVEH",
        "authorized_official_first_name": "MARJAN",
        "authorized_official_title_or_position": "CHIROPRACTOR AND FUNCTIONAL NEUROLO",
        "authorized_official_telephone_number": "707-228-8405",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC , DACNB"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Neurology",
            "state": "CA",
            "license": "DC#26964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2015; 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.