Individual provider Active NPI

Stanislav Chavik, M.D.

  • General Practice Physician
  • Tallahassee, FL
National Provider Identifier
1447675657
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
018654 Issued in PR
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

Updated by the provider on Nov 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
ACN 722FLMDGeneral Practice Physician
018654PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctor Today TLC, LLC CurrentSince Jan 12, 2016 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.

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

Verify at the official NPI Registry.