Active NPI
Marc Daquila, DC
- Chiropractor
- Bennington, VT
National Provider Identifier
1265547707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1880
- Practice address
- 160 Benmont Ave
Suite 23
Bennington, VT 05201-1873 - Phone
- (802) 447-3455
- NPI assigned
- Aug 21, 2006
- Last updated
- Apr 30, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1880 | MA | Primary |
Addresses
Primary practice location
160 Benmont Ave
Suite 23
Bennington, VT 05201-1873
Mailing address
160 Benmont Ave
Suite 23
Bennington, VT 05201-1873
Phone (802) 447-3455
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00019467 | Other | VT | BLUECROSS VT |
| 05-0411280 | Other | VT | TAX ID |
| MA-1880 | Other | MA | LICENSE MASS |
| Y36358 | Other | MA | BLUECROSS MASS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1880 | MA | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dawson & Associates, Therapy Services, LLC | Past | Accepting new patients |
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.
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- NPI 1376318428
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209513600000",
"number": "1265547707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 BENMONT AVE",
"address_2": "SUITE 23",
"city": "BENNINGTON",
"state": "VT",
"postal_code": "052011873",
"telephone_number": "802-447-3455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 BENMONT AVE",
"address_2": "SUITE 23",
"city": "BENNINGTON",
"state": "VT",
"postal_code": "052011873",
"telephone_number": "802-447-3455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAQUILA",
"first_name": "MARC",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-21",
"last_updated": "2008-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MA",
"license": "1880",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS VT",
"identifier": "00019467",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "05-0411280",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE MASS",
"identifier": "MA-1880",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS MASS",
"identifier": "Y36358",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bennington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.