Active NPI
Aydin Alimovich Chakhalidze
- Community Health Worker
- Seatac, WA
National Provider Identifier
1245558972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- MA 60141116
- Practice address
- 15245 International Blvd. Suite 210
Seatac, WA 98188 - Phone
- (206) 923-7600
- Fax
- (206) 923-7601
- NPI assigned
- May 5, 2010
- Last updated
- May 5, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | MA 60141116 | WA | Primary |
Addresses
Primary practice location
15245 International Blvd. Suite 210
Seatac, WA 98188
Mailing address
14239 S 34TH Ave #301
Tukwila, WA 98168
Phone (206) 218-2972
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA 60141116 | WA | MD | Community Health Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Highway Chiropractic | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273017600000",
"number": "1245558972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14239 S 34TH AVE #301",
"city": "TUKWILA",
"state": "WA",
"postal_code": "98168",
"telephone_number": "206-218-2972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15245 INTERNATIONAL BLVD. SUITE 210",
"city": "SEATAC",
"state": "WA",
"postal_code": "98188",
"telephone_number": "206-923-7600",
"fax_number": "206-923-7601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAKHALIDZE",
"first_name": "AYDIN",
"middle_name": "ALIMOVICH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-05-05",
"last_updated": "2010-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "WA",
"license": "MA 60141116",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seatac, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.