Individual provider Active NPI

Evan Jay Slatkin, D.C.

  • Chiropractor
  • Oakland Park, FL
National Provider Identifier
1619916517
Registry record updated Mar 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH7322 Issued in FL
Practice address
959 E Commercial Blvd
Oakland Park, FL 33334-3297
Phone
(954) 491-4437
Fax
(954) 491-4492
NPI assigned
Jun 6, 2006
Last updated
Mar 18, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH7322 FL Primary

Addresses

Primary practice location

959 E Commercial Blvd
Oakland Park, FL 33334-3297

Mailing address

PO Box 670308
Coral Springs, FL 33067-0006
Phone (954) 895-3000

Other identifiers 1

IdentifierTypeStateIssuer
381095000MedicaidFL

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH7322FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Inline Wellness Group, Inc. Chiropractor PastSince Nov 1, 2011 Accepting new patients
Inline Chiropractic Group Inc Chiropractor PastSince Jun 13, 2010 Accepting new patients

Organizations & group practices 2

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268870400000",
    "number": "1619916517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670308",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330670006",
            "telephone_number": "954-895-3000",
            "fax_number": "954-491-4492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "959 E COMMERCIAL BLVD",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333343297",
            "telephone_number": "954-491-4437",
            "fax_number": "954-491-4492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLATKIN",
        "first_name": "EVAN",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2010-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381095000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2010; 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.