Russell Bradley Rottacker, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

15553 Issued in CA

Practice address

321 N. Main St
Manteca, CA 95336

Phone

(209) 824-8160

Fax

(209) 824-8391

NPI assigned

Feb 9, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Rottacker Chiropractic

  • Clinic/Center
  • Manteca, CA
  • NPI 1700518404
  NPD (past) Authorized official
• Bettina Scheinuck, D.C. a Chiropractic Corp

  • Chiropractor
  • Manteca, CA
  • NPI 1861701831
  NPD (past)
• Gary S Lowe DC a Chiropractic Corp

  • Chiropractor
  • Manteca, CA
  • NPI 1962702944
  NPD (past)

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1215900238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 N. MAIN ST",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "95336",
            "telephone_number": "209-824-8160",
            "fax_number": "209-824-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 N. MAIN ST",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "95336",
            "telephone_number": "209-824-8160",
            "fax_number": "209-824-8391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTTACKER",
        "first_name": "RUSSELL",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "15553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nery Rosas-Rivas
• Janice Sue Ross, RCP
• Rotolo Behavioral Support Services LLC
• Ashley Rotolo
• Rottacker Chiropractic
• Raven Royal
• Maricel Ruffy
• Yesica Ruiz Ruiz, PHYSICAL THERAPY
• Russell P Carter Jr MD Inc
• Rally Respiandor Rutaquio

• Chiropractor in Manteca, CA
• Providers in Manteca, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.