Active NPI
Staci Marie Vella, DC
- Chiropractor
- Virginia Beach, VA
National Provider Identifier
1417045832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 0104000795
- Practice address
- 4224 Holland Road
Suite 110
Virginia Beach, VA 23452-1900 - Phone
- (757) 486-4772
- Fax
- (757) 486-6511
- NPI assigned
- Oct 11, 2006
- Sex
- Female
- Sole proprietor
- No
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 | 0104000795 | VA | Primary |
Addresses
Primary practice location
4224 Holland Road
Suite 110
Virginia Beach, VA 23452-1900
Mailing address
4224 Holland Road
Suite 110
Virgnia Beach, VA 23452-1900
Phone (757) 486-4772
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35822 | Other | MAMSI | |
| 1024175 | Other | AMERICAN SPECIALTY HEALTH | |
| 330556 | Other | VA | ANTHEM |
| 609393 | Other | ACN |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417045832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4224 HOLLAND ROAD",
"address_2": "SUITE 110",
"city": "VIRGNIA BEACH",
"state": "VA",
"postal_code": "234521900",
"telephone_number": "757-486-4772",
"fax_number": "757-486-6511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4224 HOLLAND ROAD",
"address_2": "SUITE 110",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234521900",
"telephone_number": "757-486-4772",
"fax_number": "757-486-6511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VELLA",
"first_name": "STACI",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "VA",
"license": "0104000795",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "35822",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN SPECIALTY HEALTH",
"identifier": "1024175",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "330556",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACN",
"identifier": "609393",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
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.