Individual provider Active NPI

Nicholas A Waslyn, DC

  • Chiropractor
  • Lakeland, FL
National Provider Identifier
1376685792
Registry record updated Apr 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH6094 Issued in FL
Practice address
4406 S Florida Ave
Suite 25
Lakeland, FL 33813-2182
Phone
(863) 701-0109
Fax
(863) 701-0309
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH6094 FL Primary

Addresses

Primary practice location

4406 S Florida Ave
Suite 25
Lakeland, FL 33813-2182

Mailing address

4406 S Florida Ave
Suite 25
Lakeland, FL 33813-2182
Phone (863) 701-0109

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
005637NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Stan Zemankiewicz M D PH D P a PastSince May 2, 2018 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240444800000",
    "number": "1376685792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4406 S FLORIDA AVE",
            "address_2": "SUITE 25",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132182",
            "telephone_number": "863-701-0109",
            "fax_number": "863-701-0309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4406 S FLORIDA AVE",
            "address_2": "SUITE 25",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132182",
            "telephone_number": "863-701-0109",
            "fax_number": "863-701-0309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASLYN",
        "first_name": "NICHOLAS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2009-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH6094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2009; 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.