Organization Active NPI

Vella Chiropractic Corp

  • Chiropractor
  • Palm Desert, CA
National Provider Identifier
1164099180
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
VELLA CHIROPRACTIC CORP
Practice address
72171 Highway 111 Ste 102a
Palm Desert, CA 92260-2781
Phone
(760) 636-1540
Fax
(760) 565-5243
NPI assigned
Jun 8, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Authorized official

Name
Samuel Vella, D.C.NPI 1245238054
Title
Ceo
Phone
(760) 636-1540

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 Primary

Addresses

Primary practice location

72171 Highway 111 Ste 102a
Palm Desert, CA 92260-2781

Mailing address

72171 Highway 111 Ste 102a
Palm Desert, CA 92260-2781
Phone (760) 636-1540

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220118000878 CA Part B Supplier - Clinic/Group Practice 3577955822 Receives reassigned benefits from 1 practitioner
Practice locations: Palm Desert, CA

National Provider Directory

National Provider Directory

Locations

73345 Highway 111
Ste 202
Palm Desert, CA 92260
Phone (760) 636-1540

72171 Highway 111
Ste 102A
Palm Desert, CA 92260
Phone (760) 636-1540

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": "1623110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729728000000",
    "number": "1164099180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72171 HIGHWAY 111 STE 102A",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922602781",
            "telephone_number": "760-636-1540",
            "fax_number": "760-565-5243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72171 HIGHWAY 111 STE 102A",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922602781",
            "telephone_number": "760-636-1540",
            "fax_number": "760-565-5243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VELLA CHIROPRACTIC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-08",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "VELLA",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "760-636-1540",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Desert, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.