Individual provider Active NPI

Korosh Shakeri, D.C.

  • Chiropractor
  • Berkeley, CA
National Provider Identifier
1497951958
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC28165 Issued in CA
Practice address
3280 Adeline St
Berkeley, CA 94703-2439
Phone
(510) 547-1222
Fax
(510) 547-8219
NPI assigned
Jun 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC28165 CA Primary

Addresses

Primary practice location

3280 Adeline St
Berkeley, CA 94703-2439

Mailing address

3280 Adeline St
Berkeley, CA 94703-2439
Phone (510) 547-1222

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DC28165CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497951958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3280 ADELINE ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947032439",
            "telephone_number": "510-547-1222",
            "fax_number": "510-547-8219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 ADELINE ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947032439",
            "telephone_number": "510-547-1222",
            "fax_number": "510-547-8219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKERI",
        "first_name": "KOROSH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC28165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.