Individual provider Active NPI

Robert J Indelicato, DC

  • Chiropractor
  • Bradenton, FL
National Provider Identifier
1295872463
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH8841 Issued in FL
Practice address
239 301 Blvd E
Suite H
Bradenton, FL 34208-4430
Phone
(941) 746-2612
Fax
(941) 746-2789
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH8841 FL Primary
Chiropractor 111N00000X X004843-1 NY

Addresses

Primary practice location

239 301 Blvd E
Suite H
Bradenton, FL 34208-4430

Mailing address

239 301 Blvd E
Suite H
Bradenton, FL 34208-4430
Phone (941) 746-2612

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

LicenseStateTypeSpecialty
CH8841FLMDChiropractor
X004843-1NYMDChiropractor
004843NYMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Robert J. Indelicato DC Chiropractor CurrentSince Jan 1, 1990 Accepting new patients

Locations

407 6th Ave E
Bradenton, FL 34208
Phone (941) 746-2612

239 301 Blvd E
Ste H
Bradenton, FL 34208
Phone (941) 746-2612

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295872463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 301 BLVD E",
            "address_2": "SUITE H",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342084430",
            "telephone_number": "941-746-2612",
            "fax_number": "941-746-2789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 301 BLVD E",
            "address_2": "SUITE H",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342084430",
            "telephone_number": "941-746-2612",
            "fax_number": "941-746-2789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INDELICATO",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8841",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X004843-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.