Individual provider Active NPI

David M. Fano, D.C.

  • Chiropractor
  • Montville, NJ
National Provider Identifier
1447348057
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MC003891 Issued in NJ
Practice address
74 Horseneck Rd
Montville, NJ 07045-9303
Phone
(973) 265-0700
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X MC003891 NJ Primary

Addresses

Primary practice location

74 Horseneck Rd
Montville, NJ 07045-9303

Mailing address

74 Horseneck Rd
Montville, NJ 07045-9303
Phone (973) 265-7000

Other practice location 1

2 Changebridge Rd
Suite 104
Montville, NJ 07045-8947
Phone (973) 265-0700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040811000333 NJ Practitioner - Chiropractic 5193797082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

74 Horseneck Rd
Montville, NJ 07045-9303
Phone (973) 265-0700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC003891NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Clifton Spine Sports & Rehabilitation Chiropractor Past Accepting new patients
Community Support Services of NJ Past Accepting new patients

Organizations & group practices 3

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1447348057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 HORSENECK RD",
            "city": "MONTVILLE",
            "state": "NJ",
            "postal_code": "070459303",
            "telephone_number": "973-265-7000",
            "fax_number": "973-265-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 HORSENECK RD",
            "city": "MONTVILLE",
            "state": "NJ",
            "postal_code": "070459303",
            "telephone_number": "973-265-0700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Changebridge Rd",
            "address_2": "Suite 104",
            "address_purpose": "LOCATION",
            "city": "Montville",
            "state": "NJ",
            "postal_code": "070458947",
            "country_code": "US",
            "telephone_number": "973-265-0700",
            "fax_number": "973-265-0799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FANO",
        "first_name": "DAVID",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "MC003891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; 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.