Individual provider Active NPI

Emery Vaughn Pitcel, DC

  • Chiropractor
  • State College, PA
National Provider Identifier
1194255414
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC011569 Issued in PA
Practice address
1402 S Atherton St Ste 204
State College, PA 16801-6255
Phone
(814) 441-5532
Fax
(814) 556-2110
NPI assigned
Jun 19, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038013115 IL
Chiropractor 111N00000X DC011569 PA Primary

Addresses

Primary practice location

1402 S Atherton St Ste 204
State College, PA 16801-6255

Mailing address

138 W Whitehall Rd
State College, PA 16801-5931
Phone (586) 255-9170

Other practice location 1

123 Mount Nittany Rd
Lemont, PA 16851-9054
Phone (586) 255-9170

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210324002596 PA Practitioner - Chiropractic 9830506526 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Williamsport Wellness Center Inc.Group PAC ID 9335535905, 5 clinicians

Practice addresses (Care Compare)

1355 Four Mile Dr
Williamsport, PA 17701-1932
Phone (570) 322-1776

1402 S Atherton St
Suite 204
State College, PA 16801-6255
Phone (814) 441-5532

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038013115ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Williamsport Wellness Center Inc. Chiropractor CurrentSince Apr 4, 2022 Accepting new patients
Rothrock Chiropractic and Rehabilitation LLC Chiropractor CurrentSince Nov 1, 2021 Accepting new patients

Locations

1402 S Atherton St
Ste 204
State College, PA 16801
Phone (814) 441-5532

1355 Four Mile Dr
Williamsport, PA 17701
Phone (570) 322-1776

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.

NPI Registry JSON

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1194255414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 W WHITEHALL RD",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168015931",
            "telephone_number": "586-255-9170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 S ATHERTON ST STE 204",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168016255",
            "telephone_number": "814-441-5532",
            "fax_number": "814-556-2110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 Mount Nittany Rd",
            "address_purpose": "LOCATION",
            "city": "Lemont",
            "state": "PA",
            "postal_code": "168519054",
            "country_code": "US",
            "telephone_number": "586-255-9170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PITCEL",
        "first_name": "EMERY",
        "middle_name": "VAUGHN",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-19",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038013115",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC011569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.