Michael John Riccoboni, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3062 Issued in NC

Practice address

6774 River Center Drive
Clemmons, NC 27012-8999

Phone

(336) 766-5935

Fax

(336) 766-5365

NPI assigned

Nov 9, 2005

Last updated

Nov 10, 2011By the provider in NPPES

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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2002

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clemmons Village Chiropractic PLLC

  • Chiropractor
  • Clemmons, NC
  • NPI 1760559215
  Medicare reassignment NPD Authorized official
• DDMR PLLC

  dba Health Source of Monroe

  • Clinic/Center
  • Monroe, NC
  • NPI 1851692891
  NPD (past) Authorized official

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1013998848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6774 RIVER CENTER DRIVE",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128999",
            "telephone_number": "336-766-5935",
            "fax_number": "336-766-5365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6774 RIVER CENTER DRIVE",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128999",
            "telephone_number": "336-766-5935",
            "fax_number": "336-766-5365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICCOBONI",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUE SHIELD NUM",
            "identifier": "085HM",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALL OTHER NETWORKS",
            "identifier": "41-2094316",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89085HM",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN PROVIDER NUMBER",
            "identifier": "648441",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Regency Care of Clemmons, LLC (Regency Care of Clemmons)
• Rehab Medicine of the Carolinas PLLC
• Esther Marie Remeta, D.C.
• Restoration Healthcare, PLLC
• Riccobene & Associates I, DDS, P.a. (Riccobene Associates Family Dentistry - Clemmons)
• Stephanie Amber Rice, PA
• Rebecca Faith Richardson
• Ridge Care Management, Inc.
• Maria Riederer, PHARMD
• Jeffrey William Rinehart, LPA

• Chiropractor in Clemmons, NC
• Providers in Clemmons, NC by specialty
• Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; 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.