Providence Chiropractic Clinic Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

PROVIDENCE CHIROPRACTIC CLINIC INC

Practice address

1637 Mineral Spring Avenue Suite 201
North Providence, RI 02904

Phone

(401) 354-5120

Fax

(401) 354-5122

NPI assigned

Dec 28, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Michael Anthony Lancellotti, DCNPI 1427040336

Title

Doctor of Chiropractic

Phone

(401) 354-5120

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in RI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Anthony Lancellotti, D.C.

  • Chiropractor
  • North Providence, RI
  • NPI 1427040336
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1043376684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1637 MINERAL SPRING AVENUE SUITE 201",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "02904",
            "telephone_number": "401-354-5120",
            "fax_number": "401-354-5122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1637 MINERAL SPRING AVENUE SUITE 201",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "02904",
            "telephone_number": "401-354-5120",
            "fax_number": "401-354-5122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE CHIROPRACTIC CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A",
        "authorized_official_last_name": "LANCELLOTTI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "401-354-5120",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "720028401",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS RI",
            "identifier": "0000003521",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "400742",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED",
            "identifier": "4400421",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Peter Joseph Ragosta Sr., RPH
• Martha Williams Ragsdale, DPT
• M.Taghi Rajabiun, M.D.
• Victoria Ramos, DPT
• Jerome Anthony Rao, D.P.T.

• All providers in North Providence, RI
• Chiropractor in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; 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.