Organization Active NPI

Novelli Chiropractic Clinic, Inc.

  • Chiropractor
  • North Canton, OH
National Provider Identifier
1164699831
Registry record updated May 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1154 Issued in OH
Legal business name
NOVELLI CHIROPRACTIC CLINIC, INC.
Practice address
525 N Main St
North Canton, OH 44720-2566
Phone
(330) 497-1942
Fax
(330) 497-0619
NPI assigned
May 13, 2008
Last updated
May 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2008

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

Authorized official

Name
Timothy P Novelli, D.C.NPI 1104928415
Title
President
Phone
(330) 497-1942

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
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
O20120305000309 OH Part B Supplier - Clinic/Group Practice 3274792692 Receives reassigned benefits from 2 practitioners
Practice locations: North Canton, OH

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210636800000",
    "number": "1164699831",
    "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": {
        "organization_name": "NOVELLI CHIROPRACTIC CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-13",
        "last_updated": "2008-05-13",
        "status": "A",
        "authorized_official_last_name": "NOVELLI",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-497-1942",
        "authorized_official_credential": "D.C."
    },
    "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 May 13, 2008; 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.