Active NPI
Vincent T Mattiello, DC
- Chiropractor
- Debary, FL
National Provider Identifier
1306855168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH9167
- Practice address
- 2845 Enterprise Rd
Suite 101
Debary, FL 32713-5224 - Phone
- (386) 668-9200
- Fax
- (386) 668-9200
- NPI assigned
- Aug 7, 2006
- Last updated
- Mar 20, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH9167 | FL | Primary |
Addresses
Primary practice location
2845 Enterprise Rd
Suite 101
Debary, FL 32713-5224
Mailing address
29 Big Buck TRL
Ormond Beach, FL 32174-4279
Phone (386) 405-0652
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spine Soldier Chiropractic Clinics | Chiropractor | Past | Accepting new patients |
| Kathleen Link DC PA | Chiropractor | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Chiropractor
- Ormond Beach, FL
- NPI 1285340927
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363737600000",
"number": "1306855168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 BIG BUCK TRL",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321744279",
"telephone_number": "386-405-0652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2845 ENTERPRISE RD",
"address_2": "SUITE 101",
"city": "DEBARY",
"state": "FL",
"postal_code": "327135224",
"telephone_number": "386-668-9200",
"fax_number": "386-668-9200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTIELLO",
"first_name": "VINCENT",
"middle_name": "T",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-07",
"last_updated": "2013-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH9167",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Debary, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.