Mariela Betina Perosino, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR007819 Issued in GA

Practice address

611 Holcomb Bridge Rd
Ste a
Roswell, GA 30076-1769

Phone

(678) 205-8432

Fax

(678) 205-8443

NPI assigned

Apr 11, 2007

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Networks

• FL HMO D-SNP
• devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
• TN PPO
• devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
• devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
• devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
• AL HMO
• devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
• FL HMO C-SNP
• FL HMO
• AL HMO D-SNP
• TN PPO C-SNP

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282176000000",
    "number": "1003039611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 HOLCOMB BRIDGE RD",
            "address_2": "SUITE A",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761769",
            "telephone_number": "678-205-8432",
            "fax_number": "678-205-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 HOLCOMB BRIDGE RD",
            "address_2": "STE A",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761769",
            "telephone_number": "678-205-8432",
            "fax_number": "678-205-8443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEROSINO",
        "first_name": "MARIELA",
        "middle_name": "BETINA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2010-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR007819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Roswell, GA
• Providers in Roswell, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2010; 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.