Ahava-5772, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH7712 Issued in FL

Legal business name

AHAVA-5772, LLC

Practice address

5540 Pga Boulevard
Suite 100
Palm Beach Gardens, FL 33418

Phone

(561) 596-2714

NPI assigned

Aug 31, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Beth Joy Kozak, D.C.NPI 1265733604

Title

Manager

Phone

(561) 596-2714

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Namaste Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Beth Joy Kozak, D.C.

  • Chiropractor
  • Palm Beach Gardens, FL
  • NPI 1265733604
  Medicare reassignment NPD Authorized official
• Taylor Robinson, DC

  • Chiropractor
  • Palm Beach Gardens, FL
  • NPI 1952131013
  NPD
• Stefan P. Kozak, M.D.

  • Family Medicine Physician
  • Springfield, IL
  • NPI 1265530596
  NPD (past)

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472774400000",
    "number": "1417403221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5540 PGA BOULEVARD",
            "address_2": "SUITE 100",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "33418",
            "telephone_number": "561-596-2714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5540 PGA BOULEVARD",
            "address_2": "SUITE 100",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "33418",
            "telephone_number": "561-596-2714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AHAVA-5772, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-31",
        "last_updated": "2016-09-02",
        "status": "A",
        "authorized_official_last_name": "KOZAK",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "JOY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "561-596-2714",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "ES056Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Namaste Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alyssa Nicole Ager
• Deeya Aggarwal, DPT
• Agh, LLC
• Linda Agosto, MMHC
• Nicolle Aguado
• Stacie Ahee, D.C.
• Ibrar Ahmad
• Ahmed El-Haddad MD P a
• Rayhan Ahmed
• Seham Ahmed, PHARMD

• Chiropractor in Palm Beach Gardens, FL
• Providers in Palm Beach Gardens, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.