Kellie Anne Dattilo

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

STUDENT Issued in NY

Practice address

18 Seneca Manor Dr
Seneca Falls, NY 13148-2319

Phone

(860) 689-3406

NPI assigned

Mar 11, 2024

Sex

Female

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 NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Chosen Spot Chiropractic & Wellness PLLC

  • Chiropractor
  • Canandaigua, NY
  • NPI 1144665290
  Medicare reassignment NPD
• DRD Healthsource Chiropractic PLLC

  dba HealthSource Chiropractic

  • Sports Physician Chiropractor
  • Rochester, NY
  • NPI 1245479435
  Medicare reassignment NPD

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

{
    "created_epoch": "1710115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1285492447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 SENECA MANOR DR",
            "city": "SENECA FALLS",
            "state": "NY",
            "postal_code": "131482319",
            "telephone_number": "860-689-3406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 SENECA MANOR DR",
            "city": "SENECA FALLS",
            "state": "NY",
            "postal_code": "131482319",
            "telephone_number": "860-689-3406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATTILO",
        "first_name": "KELLIE",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-11",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "STUDENT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Allen Crawford, D.C.
• Isaac Clair Cristoveanu
• Christopher Cruz
• Brian Matthew Cunningham, D.C.
• Sarah Louise D'Acquisto, AGNP-C
• Tracy Dean, RN
• Virginia Dejohn, SLP
• Kathy J Dooley, DC
• Joseph L Drexler, DDS
• Darlene Easton, LAC DIPLOMAT CHINESE

• Chiropractor in Seneca Falls, NY
• Providers in Seneca Falls, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; 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.