Individual provider Active NPI

Debra Yerman Cholodenko, D.C.

  • Chiropractor
  • Encino, CA
National Provider Identifier
1508898545
Registry record updated Jun 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
12864 Issued in CA
Practice address
17514 Ventura Blvd
Ste 104
Encino, CA 91316-3893
Phone
(818) 995-4300
Fax
(818) 995-4301
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 12864 CA Primary

Addresses

Primary practice location

17514 Ventura Blvd
Ste 104
Encino, CA 91316-3893

Mailing address

17514 Ventura Blvd
Ste 104
Encino, CA 91316-3893
Phone (818) 995-4300

Other names 1

  • Dr. Debra Yerman Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090604000558 CA Practitioner - Chiropractic 2769532134 Practice locations: Tarzana, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1978
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

18740 Ventura Blvd
Suite 306
Tarzana, CA 91356-6314
Phone (818) 995-4300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12864CAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560988800000",
    "number": "1508898545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17514 VENTURA BLVD",
            "address_2": "STE 104",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913163893",
            "telephone_number": "818-995-4300",
            "fax_number": "818-995-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17514 VENTURA BLVD",
            "address_2": "STE 104",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913163893",
            "telephone_number": "818-995-4300",
            "fax_number": "818-995-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOLODENKO",
        "first_name": "DEBRA",
        "middle_name": "YERMAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2019-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "12864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "YERMAN",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.