Individual provider Active NPI

Wayne Robert Eiban, DC

  • Chiropractor
  • Virginia Beach, VA
National Provider Identifier
1285643429
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104000382 Issued in VA
Practice address
5301 Providence Rd
Suite50
Virginia Beach, VA 23464-4128
Phone
(757) 495-2228
Fax
(757) 495-2216
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104000382 VA Primary

Addresses

Primary practice location

5301 Providence Rd
Suite50
Virginia Beach, VA 23464-4128

Mailing address

5301 Providence Rd
Suite50
Virginia Beach, VA 23464-4128
Phone (757) 495-2228

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104000382VAMDChiropractor
00VAMDCritical Care Medicine Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1285643429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 PROVIDENCE RD",
            "address_2": "SUITE50",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644128",
            "telephone_number": "757-495-2228",
            "fax_number": "757-495-2216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 PROVIDENCE RD",
            "address_2": "SUITE50",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644128",
            "telephone_number": "757-495-2228",
            "fax_number": "757-495-2216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIBAN",
        "first_name": "WAYNE",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104000382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; 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.