MEDICARE: ORIGINS CHIROPRACTIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1033064142
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORIGINS CHIROPRACTIC

Provider Business Mailing Address
First Line	:	8475 S EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-2862
Country	:	US
Telephone Number	:	702-544-0873
Fax Number	:

Provider Business Practice Location Address
First Line	:	9900 ROSE CHARMONT ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89183-7500
Country	:	US
Telephone Number	:	702-544-0873
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. ANTHONY PAYAN
Credential	:	DC
Telephone Number	:	702-544-0873

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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Directions to “ORIGINS CHIROPRACTIC ” Practice Location

Language	Start Address	Practice Location

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