Individual provider Active NPI

Vahagn Jack Keshishyan, D.C.

  • Chiropractor
  • Burbank, CA
National Provider Identifier
1366428344
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
25153 Issued in CA
Practice address
372 E Olive Ave
Burbank, CA 91502-1215
Phone
(818) 954-0747
Fax
(818) 954-9139
NPI assigned
Dec 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 25153 CA Primary

Addresses

Primary practice location

372 E Olive Ave
Burbank, CA 91502-1215

Mailing address

372 E Olive Ave
Burbank, CA 91502-1215
Phone (818) 954-0747

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050421001593 CA Practitioner - Chiropractic 4183662836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Keshishian Chiropractic IncGroup PAC ID 5597908913, 2 clinicians

Practice addresses (Care Compare)

28708 Roadside Dr
Suite I
Agoura Hills, CA 91301-3300
Phone (818) 991-4685

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Slim and Slimmer Medical Associates Past Accepting new patients
Integrative Medical Associates Inc Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366428344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "372 E OLIVE AVE",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915021215",
            "telephone_number": "818-954-0747",
            "fax_number": "818-954-9139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "372 E OLIVE AVE",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915021215",
            "telephone_number": "818-954-0747",
            "fax_number": "818-954-9139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESHISHYAN",
        "first_name": "VAHAGN",
        "middle_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "25153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.