Individual provider Active NPI

Timothy P Novelli, D.C.

  • Chiropractor
  • North Canton, OH
National Provider Identifier
1104928415
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1154 Issued in OH
Practice address
525 N Main St
North Canton, OH 44720-2566
Phone
(330) 497-1942
Fax
(330) 497-0619
NPI assigned
Sep 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1154 OH Primary

Addresses

Primary practice location

525 N Main St
North Canton, OH 44720-2566

Mailing address

525 N Main St
North Canton, OH 44720-2566
Phone (330) 497-1942

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120305000354 OH Practitioner - Chiropractic 8325207749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

525 N Main St
North Canton, OH 44720-2566
Phone (330) 497-1942

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1154OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Novelli Chiropractic Clinic, Inc. Chiropractor CurrentSince Sep 30, 1981 Accepting new patients
Brechbill Chiropractic LLC Chiropractor Past Accepting new patients

Locations

525 N Main St
North Canton, OH 44720
Phone (330) 497-1942

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104928415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 N MAIN ST",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447202566",
            "telephone_number": "330-497-1942",
            "fax_number": "330-497-0619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N MAIN ST",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447202566",
            "telephone_number": "330-497-1942",
            "fax_number": "330-497-0619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVELLI",
        "first_name": "TIMOTHY",
        "middle_name": "P",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.