Individual provider Active NPI

Michael E Fanelli, DC

  • Chiropractor
  • Mullica Hill, NJ
National Provider Identifier
1295701571
Registry record updated Dec 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00407900 Issued in NJ
Practice address
33 N Main St
Mullica Hill, NJ 08062-9452
Phone
(856) 478-2800
Fax
(856) 478-2804
NPI assigned
Feb 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00407900 NJ Primary

Addresses

Primary practice location

33 N Main St
Mullica Hill, NJ 08062-9452

Mailing address

33 N Main St
Mullica Hill, NJ 08062-9452
Phone (856) 478-2800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050803000195 NJ Practitioner - Chiropractic 6002844156 Practice locations: Mullica Hill, NJ

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1990
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

13 -15 S Main St
1St Floor
Mullica Hill, NJ 08062-9403

13 S Main St
Mullica Hill, NJ 08062-9403
Phone (856) 478-2800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00407900NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Fanelli Chiropractic & Muscle Treatment Chiropractor PastSince Jan 1, 1990 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482796800000",
    "number": "1295701571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 N MAIN ST",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080629452",
            "telephone_number": "856-478-2800",
            "fax_number": "856-478-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 N MAIN ST",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080629452",
            "telephone_number": "856-478-2800",
            "fax_number": "856-478-2804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANELLI",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2016-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00407900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mullica Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.