Individual provider Active NPI

Russ F. Fasolino, D.C.

  • Chiropractor
  • Steamboat Springs, CO
National Provider Identifier
1174528749
Registry record updated Nov 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2475 Issued in CO
Practice address
320 Oak Street
Steamboat Springs, CO 80477
Phone
(970) 870-8888
Fax
(970) 870-3076
NPI assigned
Jun 20, 2005
Last updated
Nov 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 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 2475 CO Primary

Addresses

Primary practice location

320 Oak Street
Steamboat Springs, CO 80477

Mailing address

PO Box 772583
320 Oak Street
Steamboat Springs, CO 80477-2583
Phone (970) 870-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2475COMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Russ Fasolino Inc. Chiropractor CurrentSince May 14, 1998 Accepting new patients

Locations

2851 Riverside Plz
Steamboat Springs, CO 80487
Phone (970) 870-8888

Organizations & group practices 1

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": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194566400000",
    "number": "1174528749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 772583",
            "address_2": "320 OAK STREET",
            "city": "STEAMBOAT SPRINGS",
            "state": "CO",
            "postal_code": "804772583",
            "telephone_number": "970-870-8888",
            "fax_number": "970-870-3076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 OAK STREET",
            "city": "STEAMBOAT SPRINGS",
            "state": "CO",
            "postal_code": "80477",
            "telephone_number": "970-870-8888",
            "fax_number": "970-870-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASOLINO",
        "first_name": "RUSS",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2007-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "2475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Steamboat Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.