Active NPI
Cameron Reza Khavarimanesh, D.C.
- Chiropractor
- Phoenix, AZ
National Provider Identifier
1326360587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 8116
- Practice address
- 4417 N 40TH St Ste 400a
Phoenix, AZ 85018 - Phone
- (480) 619-2020
- Fax
- (480) 436-5800
- NPI assigned
- Feb 15, 2010
- Last updated
- Jun 5, 2018
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 8116 | AZ | Primary |
Addresses
Primary practice location
4417 N 40TH St Ste 400a
Phoenix, AZ 85018
Mailing address
4001 E Mountain Sky Ave Ste 101
Phoenix, AZ 85044-3743
Phone (480) 619-2020
Other names 1
- Dr. Cameron Reza Khavari
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 |
|---|---|---|---|
| 8116 | AZ | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Cameron Khavari PLLC | Chiropractor | 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": "1266192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528156800000",
"number": "1326360587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4001 E MOUNTAIN SKY AVE STE 101",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850443743",
"telephone_number": "480-619-2020",
"fax_number": "480-436-5800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4417 N 40TH ST STE 400A",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85018",
"telephone_number": "480-619-2020",
"fax_number": "480-436-5800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAVARIMANESH",
"first_name": "CAMERON",
"middle_name": "REZA",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-02-15",
"last_updated": "2018-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AZ",
"license": "8116",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CAMERON",
"last_name": "KHAVARI",
"middle_name": "REZA",
"prefix": "DR.",
"credential": "D.C.",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.