NPIMap

Organization Active NPI

Wellness Chiropractic Center of Southpointe, PC

  • Chiropractor
  • Canonsburg, PA
National Provider Identifier
1285608638
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC006881L Issued in PA
Legal business name
WELLNESS CHIROPRACTIC CENTER OF SOUTHPOINTE, PC
Practice address
1001 Corporate Dr
Suite 120
Canonsburg, PA 15317-8551
Phone
(724) 743-4500
Fax
(724) 743-4501
NPI assigned
Feb 14, 2006
Last updated
Oct 16, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Authorized official

Name
Geno A Pisciottano, DCNPI 1467422998
Title
Owner
Phone
(724) 743-4500

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC006881L PA Primary

Addresses

Primary practice location

1001 Corporate Dr
Suite 120
Canonsburg, PA 15317-8551

Mailing address

1001 Corporate Dr
Suite 120
Canonsburg, PA 15317-8551
Phone (724) 743-4500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050816000695 PA Part B Supplier - Clinic/Group Practice 2668402009 Receives reassigned benefits from 1 practitioner
Practice locations: MC Murray, PA

National Provider Directory

National Provider Directory
Tax ID family
Wellness Chiropractic Center at Southpointe2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1001 Corporate Dr
Ste 120
Canonsburg, PA 15317
Phone (724) 743-4500

Practitioners & affiliated clinicians

Practitioners 2

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": "1139875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1285608638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 CORPORATE DR",
            "address_2": "SUITE 120",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153178551",
            "telephone_number": "724-743-4500",
            "fax_number": "724-743-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 CORPORATE DR",
            "address_2": "SUITE 120",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153178551",
            "telephone_number": "724-743-4500",
            "fax_number": "724-743-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS CHIROPRACTIC CENTER OF SOUTHPOINTE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-14",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "PISCIOTTANO",
        "authorized_official_first_name": "GENO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "724-743-4500",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC006881L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canonsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.