Organization Active NPI

Daniel Serpentelli III DC PA

  • Chiropractor
  • Bradenton, FL
National Provider Identifier
1114356730
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH5589 Issued in FL
Legal business name
DANIEL SERPENTELLI III DC PA
Practice address
6016 Manatee Ave W
Bradenton, FL 34209-2417
Phone
(941) 739-2225
Fax
(941) 753-6821
NPI assigned
Nov 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

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

Authorized official

Name
Dr. Daniel Serpentelli III, D.C.NPI 1720116916
Title
Owner/President
Phone
(941) 739-2225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH5589 FL Primary

Addresses

Primary practice location

6016 Manatee Ave W
Bradenton, FL 34209-2417

Mailing address

6016 Manatee Ave W
Bradenton, FL 34209-2417
Phone (941) 739-2225

Other identifiers 1

IdentifierTypeStateIssuer
22092OtherFLBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140912001191 FL Part B Supplier - Clinic/Group Practice 1456570035 Receives reassigned benefits from 1 practitioner
Practice locations: Bradenton, FL

National Provider Directory

National Provider Directory

Locations

6016 Manatee Ave W
Bradenton, FL 34209
Phone (941) 739-2225

3806 Manatee Ave W
Ste 100
Bradenton, FL 34205
Phone (941) 360-6974

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383523200000",
    "number": "1114356730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6016 MANATEE AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342092417",
            "telephone_number": "941-739-2225",
            "fax_number": "941-753-6821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6016 MANATEE AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342092417",
            "telephone_number": "941-739-2225",
            "fax_number": "941-753-6821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL SERPENTELLI III DC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-04",
        "last_updated": "2013-11-04",
        "status": "A",
        "authorized_official_last_name": "SERPENTELLI",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "941-739-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH5589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "22092",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; 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.