Individual provider Active NPI

Diana Vavikova, DC

  • Independent Medical Examiner Chiropractor
  • New York, NY
National Provider Identifier
1750579538
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Medical Examiner ChiropractorTaxonomy code 111NI0013X
License
X009246 Issued in NY
Practice address
1 Maiden Lane, 4TH Floor
New York, NY 10038-3563
Phone
(212) 791-3388
Fax
(888) 268-2484
NPI assigned
Oct 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Medical Examiner Chiropractor 111NI0013X X009246 NY Primary
Chiropractor 111N00000X X009246 NY

Addresses

Primary practice location

1 Maiden Lane, 4TH Floor
New York, NY 10038-3563

Mailing address

1 Maiden Lane, 4TH Floor
New York, NY 10038
Phone (212) 791-3388

Other identifiers 1

IdentifierTypeStateIssuer
X009246OtherNYLISCENSCE

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
X009246NYMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1750579538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MAIDEN LANE, 4TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10038",
            "telephone_number": "212-791-3388",
            "fax_number": "888-268-2484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MAIDEN LANE, 4TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100383563",
            "telephone_number": "212-791-3388",
            "fax_number": "888-268-2484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAVIKOVA",
        "first_name": "DIANA",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-05",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NI0013X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Independent Medical Examiner",
            "state": "NY",
            "license": "X009246",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X009246",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISCENSCE",
            "identifier": "X009246",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; 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.