Matthew J Antonelli, DC

Individual provider Active NPI Chiropractor · Mooresville, NC

NPI 1134587173 · NPPES record last updated Dec 30, 2019

Key facts

NPI
1134587173
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
4642 (NC)
Practice address
115 Commons Dr Ste D
Mooresville, NC 28117-9264
Phone
(980) 444-0060
NPI assigned
Feb 5, 2016
Sex
Male
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Chiropractic
Education
New York Chiropractic College, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

115 Commons Dr
Suite D
Mooresville, NC 28117-9264
Phone (980) 444-0060

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160614000241 NC Practitioner - Chiropractic 3476844986 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
4642NCMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Combined Chiropractic & Acupuncture, PLLC Chiropractor Current
since May 21, 2019
Accepting new patients
Doyle Chiropractic, PLLC Chiropractor Current
since Jan 9, 2019
Accepting new patients

Locations

9630 Sherrill Estates Rd
Ste B
Huntersville, NC 28078
Phone (704) 947-7272

115 Commons Dr
Ste D
Mooresville, NC 28117
Phone (631) 721-7009

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4642 NC Yes

Addresses

Primary practice location

115 Commons Dr Ste D
Mooresville, NC 28117-9264

Mailing address

115 Commons Dr Ste D
Mooresville, NC 28117-9264
Phone (980) 444-0060

Other providers in Mooresville, NC

All providers in Mooresville, NC · Chiropractor in North Carolina

Sources for this page

Verify at the official NPI Registry.