Organization Active NPI

Petrelli Chiropractic & Rehabilitation, Inc.

  • Rehabilitation Chiropractor
  • Philadelphia, PA
National Provider Identifier
1285858852
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
DC-007963L Issued in PA
Legal business name
PETRELLI CHIROPRACTIC & REHABILITATION, INC.
Practice address
1420 Walnut St Ste 606
Philadelphia, PA 19102-4005
Phone
(215) 670-2225
Fax
(215) 670-9662
NPI assigned
Apr 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Authorized official

Name
Dr. Vincent Petrelli, D.C.NPI 1295830867
Title
Owner , President
Phone
(215) 670-2225

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
Rehabilitation ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NR0400X DC-007963L PA Primary

Addresses

Primary practice location

1420 Walnut St Ste 606
Philadelphia, PA 19102-4005

Mailing address

1420 Walnut St Ste 606
Philadelphia, PA 19102-4005
Phone (215) 670-2225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121114000285 PA Part B Supplier - Clinic/Group Practice 0345491627 Receives reassigned benefits from 1 practitioner
Practice locations: Philadelphia, PA

National Provider Directory

National Provider Directory

Locations

220 S Broad St
Fl 8
Philadelphia, PA 19102
Phone (215) 681-3335

1420 Walnut St
Ste 606
Philadelphia, PA 19102
Phone (215) 670-2225

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1285858852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 WALNUT ST STE 606",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191024005",
            "telephone_number": "215-670-2225",
            "fax_number": "215-670-9662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 WALNUT ST STE 606",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191024005",
            "telephone_number": "215-670-2225",
            "fax_number": "215-670-9662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETRELLI CHIROPRACTIC & REHABILITATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A",
        "authorized_official_last_name": "PETRELLI",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "OWNER , PRESIDENT",
        "authorized_official_telephone_number": "215-670-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "PA",
            "license": "DC-007963L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.