Nicholas J. Viviano, MD, LLC

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

015859 Issued in LA

Legal business name

NICHOLAS J. VIVIANO, MD, LLC

Practice address

7031 Highway 190 East Service Rd
Covington, LA 70433-4955

Phone

(985) 893-9464

Fax

(985) 893-9465

NPI assigned

Dec 5, 2007

Last updated

Dec 5, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Nicholas Joseph Viviano, MDNPI 1730187162

Title

Ceo

Phone

(985) 893-9464

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicholas Joseph Viviano, MD

  • Procedural Dermatology Physician
  • Covington, LA
  • NPI 1730187162
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196812800000",
    "number": "1407039050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1259",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704701259",
            "telephone_number": "985-893-9464",
            "fax_number": "985-893-9465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7031 HIGHWAY 190 EAST SERVICE RD",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704334955",
            "telephone_number": "985-893-9464",
            "fax_number": "985-893-9465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLAS J. VIVIANO, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2007-12-05",
        "status": "A",
        "authorized_official_last_name": "VIVIANO",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "985-893-9464",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "LA",
            "license": "015859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Procedural Dermatology Physician in Covington, LA
• Providers in Covington, LA by specialty
• Procedural Dermatology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.