Divan Chiropractic and Sports Rehabilitation

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2014010441 Issued in MO

Legal business name

DIVAN CHIROPRACTIC AND SPORTS REHABILITATION

Practice address

8045 Big Bend Blvd
107
Saint Louis, MO 63119-2714

Phone

(314) 961-7181

NPI assigned

Dec 29, 2014

Last updated

Dec 29, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Jana Willison

Title

Office Manager

Phone

(314) 961-7181

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1419811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419811200000",
    "number": "1942698998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8045 BIG BEND BLVD",
            "address_2": "SUITE 107",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631192714",
            "telephone_number": "314-961-7181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8045 BIG BEND BLVD",
            "address_2": "107",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631192714",
            "telephone_number": "314-961-7181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVAN CHIROPRACTIC AND SPORTS REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-29",
        "last_updated": "2014-12-29",
        "status": "A",
        "authorized_official_last_name": "WILLISON",
        "authorized_official_first_name": "JANA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "314-961-7181",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2014010441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Jacob Dittlinger, OD
• Larina Jolynn Ditto, MSW
• Nicole Niara Ditto
• Vijayalakshmi Divakaran, ARNP, BC
• Richard M Divalerio, M.D.
• Nicholas Divan, D.C.
• Taraneh Maryam Divanbeigi, FNP-C
• Chirag Divecha, MD
• Diverse Health Services LLC
• Diverse Ventures, LLC

• Chiropractor in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2014; 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.