Individual provider Active NPI

Tavia Reyes

  • Chiropractor
  • St Petersburg, FL
National Provider Identifier
1205672169
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH14617 Issued in FL
Practice address
9500 Koger Blvd N
Saint Petersburg, FL 33702-2483
Phone
(727) 278-0969
NPI assigned
Jul 1, 2024
Last updated
Jul 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH14617 FL Primary

Addresses

Primary practice location

9500 Koger Blvd N
Saint Petersburg, FL 33702-2483

Mailing address

530 23Rd Ave SE
Saint Petersburg, FL 33705-3308
Phone (727) 278-0969

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CH14617FLMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1205672169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 23RD AVE SE",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337053308",
            "telephone_number": "727-278-0969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 KOGER BLVD N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337022483",
            "telephone_number": "727-278-0969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "TAVIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH14617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 1, 2024; 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.