Individual provider Active NPI

Robert E Lavictoire, CH

  • Chiropractor
  • Washington, NC
National Provider Identifier
1861593469
Registry record updated Dec 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1499 Issued in NC
Practice address
818 W 5TH St
Washington, NC 27889-4204
Phone
(252) 946-0148
Fax
(252) 946-0148
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1499 NC Primary

Addresses

Primary practice location

818 W 5TH St
Washington, NC 27889-4204

Mailing address

818 W 5TH St
Washington, NC 27889-4204
Phone (252) 946-0148

Other identifiers 2

IdentifierTypeStateIssuer
89-08551MedicaidNC
08551OtherBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090304000371 NC Practitioner - Chiropractic 5395835797 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1984
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

818 W 5TH St
Washington, NC 27889-4204
Phone (252) 946-0148

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1499NCMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Robert E Lavictoire DC PC Chiropractor CurrentSince Oct 22, 2007 Accepting new patients

Locations

818 W 5th St
Washington, NC 27889
Phone (252) 946-0148

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197590400000",
    "number": "1861593469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 W 5TH ST",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278894204",
            "telephone_number": "252-946-0148",
            "fax_number": "252-946-0148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 W 5TH ST",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278894204",
            "telephone_number": "252-946-0148",
            "fax_number": "252-946-0148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVICTOIRE",
        "first_name": "ROBERT",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "CH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "1499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89-08551",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "08551",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2007; 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.