Individual provider Active NPI

Kevin Morales Avila

  • Chiropractor
  • Mayaguez, PR
National Provider Identifier
1518638345
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
801 Issued in PR
Practice address
27 Calle Dr Nelson Perea Edificio Doctor's Center
Suite 202
Mayaguez, PR 00680
Phone
(787) 804-4100
NPI assigned
Sep 22, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 801 PR Primary

Addresses

Primary practice location

27 Calle Dr Nelson Perea Edificio Doctor's Center
Suite 202
Mayaguez, PR 00680

Mailing address

PO Box 210
Anasco, PR 00610-0210
Phone (787) 309-4828

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250108001053 PR Practitioner - Chiropractic 7719414846 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
801PRMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Functional Spine Chiropractic LLC Chiropractor CurrentSince Dec 13, 2024 Accepting new patients

Locations

27 Calle Dr Nelson Perea
Ste 202
Mayaguez, PR 00680
Phone (787) 804-4100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1632268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1518638345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 210",
            "city": "ANASCO",
            "state": "PR",
            "postal_code": "006100210",
            "telephone_number": "787-309-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 CALLE DR NELSON PEREA EDIFICIO DOCTOR'S CENTER",
            "address_2": "SUITE 202",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00680",
            "telephone_number": "787-804-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES AVILA",
        "first_name": "KEVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-22",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PR",
            "license": "801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.