Active NPI
Stanislav Chavik, M.D.
- General Practice Physician
- Tallahassee, FL
National Provider Identifier
1447675657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 018654
- Practice address
- 2181 Orange Ave E
Tallahassee, FL 32311-6144 - Phone
- (850) 513-7310
- NPI assigned
- Feb 25, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | ACN 722 | FL | |
| General Practice Physician | 208D00000X | 018654 | PR | Primary |
Addresses
Primary practice location
2181 Orange Ave E
Tallahassee, FL 32311-6144
Mailing address
2181 Orange Ave E
Tallahassee, FL 32311-6144
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170208001755 | FL | Practitioner - General Practice | 8224311675 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ACN 722 | FL | MD | General Practice Physician |
| 018654 | PR | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Doctor Today TLC, LLC | Current | Accepting new patients | |
| Jackson County Memorial Hospital Authority | Past | Accepting new patients | |
| Hospital Authority of the City of Bainbridge and Decatur County | Past | Accepting new patients |
Locations
4435 US Highway 98 N
Lakeland, FL 33809
Phone (863) 858-8000
3810 S Florida Ave
Lakeland, FL 33813
Phone (863) 619-5100
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.
-
- Multi-Specialty Clinic/Center
- Bainbridge, GA
- NPI 1053388256
-
- General Acute Care Hospital
- Altus, OK
- NPI 1093763781
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636934400000",
"number": "1447675657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2181 ORANGE AVE E",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323116144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2181 ORANGE AVE E",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323116144",
"telephone_number": "850-513-7310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAVIK",
"first_name": "STANISLAV",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-02-25",
"last_updated": "2021-11-15",
"certification_date": "2021-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "FL",
"license": "ACN 722",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "018654",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tallahassee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.