Organization Active NPI

Pettinato Chiropractic Center PC

Doing business as Healthyways Sports and Occupational Medicine

  • Chiropractor
  • Gibsonia, PA
National Provider Identifier
1184741480
Registry record updated Dec 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC006233L Issued in PA
Legal business name
PETTINATO CHIROPRACTIC CENTER PC
Doing business as
Healthyways Sports and Occupational Medicine
Practice address
5420 William Flynn Hwy
Gibsonia, PA 15044-9652
Phone
(724) 444-6644
NPI assigned
Mar 23, 2007
Last updated
Dec 13, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2016

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

Authorized official

Name
Dr. Joseph B Pettinato, D.C.NPI 1386600096
Title
Owner
Phone
(724) 444-6644

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 DC006233L PA Primary

Addresses

Primary practice location

5420 William Flynn Hwy
Gibsonia, PA 15044-9652

Mailing address

5420 William Flynn Hwy
Gibsonia, PA 15044-9652
Phone (724) 444-6644

Other identifiers 3

IdentifierTypeStateIssuer
311810OtherPAUPMC
001614086MedicaidPA
790678OtherPABLUE CROSSBLUE SHIELD

Other names 1

  • Healthyways Sports and Occupational Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041130000606 PA Part B Supplier - Clinic/Group Practice 2264497379 Receives reassigned benefits from 5 practitioners
Practice locations: Gibsonia, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481587200000",
    "number": "1184741480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 WILLIAM FLYNN HWY",
            "city": "GIBSONIA",
            "state": "PA",
            "postal_code": "150449652",
            "telephone_number": "724-444-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5420 WILLIAM FLYNN HWY",
            "city": "GIBSONIA",
            "state": "PA",
            "postal_code": "150449652",
            "telephone_number": "724-444-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETTINATO CHIROPRACTIC CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2016-12-13",
        "status": "A",
        "authorized_official_last_name": "PETTINATO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "724-444-6644",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC006233L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC",
            "identifier": "311810",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001614086",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSSBLUE SHIELD",
            "identifier": "790678",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthyways Sports and Occupational Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gibsonia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; 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.