Nathan Sivananda, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC022167 Issued in CA

Practice address

1180 S Mount Shasta Blvd
Suite C
Mount Shasta, CA 96067-2764

Phone

(530) 926-1072

Fax

(530) 926-1072

NPI assigned

Jul 31, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73477

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.

• Mountain Valleys Health Centers

  • Federally Qualified Health Center (FQHC)
  • Bieber, CA
  • NPI 1356438261

  CA

  Medicare reassignment NPD
• Mount Shasta Chiropractic & Wellness

  • Chiropractor
  • Mount Shasta, CA
  • NPI 1255886503
  NPD (past) Authorized official
• Mountain Valleys Health Centers

  • Federally Qualified Health Center (FQHC)
  • Dorris, CA
  • NPI 1013088582
  NPD
• Mountain Valleys Health Centers

  • Federally Qualified Health Center (FQHC)
  • Mount Shasta, CA
  • NPI 1588470025
  NPD

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

{
    "created_epoch": "1343692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343692800000",
    "number": "1992051650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 S MOUNT SHASTA BLVD",
            "address_2": "SUITE C",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960672764",
            "telephone_number": "530-926-1072",
            "fax_number": "530-926-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 S MOUNT SHASTA BLVD",
            "address_2": "SUITE C",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960672764",
            "telephone_number": "530-926-1072",
            "fax_number": "530-926-1072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVANANDA",
        "first_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-31",
        "last_updated": "2012-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC022167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Mount Shasta, CA
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.