Active NPI
David Anthony Vargas, D.C.,L.AC.
- Nutrition Chiropractor
- Fort Wayne, IN
National Provider Identifier
1730233073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Chiropractor
- License
- 08001496
- Practice address
- 3621 Lake Ave
Fort Wayne, IN 46805-5539 - Phone
- (260) 422-9580
- NPI assigned
- Jan 23, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Chiropractor | 111NN1001X | 08001496 | IN | Primary |
Addresses
Primary practice location
3621 Lake Ave
Fort Wayne, IN 46805-5539
Mailing address
3621 Lake Ave
Fort Wayne, IN 46805-5539
Phone (260) 422-9580
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000211506 | Other | IN | ANTHEM |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 08001496 | IN | MD | Nutrition Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730233073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3621 LAKE AVE",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468055539",
"telephone_number": "260-422-9580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3621 LAKE AVE",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468055539",
"telephone_number": "260-422-9580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VARGAS",
"first_name": "DAVID",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "D.C.,L.AC.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111NN1001X",
"taxonomy_group": "",
"desc": "Chiropractor, Nutrition",
"state": "IN",
"license": "08001496",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000211506",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
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.