Individual provider Active NPI

Monya Tavakoli, DC

  • Chiropractor
  • Fairfax, VA
National Provider Identifier
1508257890
Registry record updated Feb 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104-557229 Issued in VA
Practice address
9693 Main St Ste C
Fairfax, VA 22031-3771
Phone
(703) 277-9590
NPI assigned
Feb 9, 2015
Last updated
Feb 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104-557229 VA Primary

Addresses

Primary practice location

9693 Main St Ste C
Fairfax, VA 22031-3771

Mailing address

9693 Main St Ste C
Fairfax, VA 22031-3771

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
0104-557229VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Care Inc Chiropractor Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1423440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423440000000",
    "number": "1508257890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9693 MAIN ST STE C",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220313771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9693 MAIN ST STE C",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220313771",
            "telephone_number": "703-277-9590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVAKOLI",
        "first_name": "MONYA",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-09",
        "last_updated": "2015-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104-557229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; 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.