Organization Active NPI

Robert J Decubellis DC PA

  • Nutrition Chiropractor
  • Sarasota, FL
National Provider Identifier
1447571906
Registry record updated Jun 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
CH 5969 Issued in FL
Legal business name
ROBERT J DECUBELLIS DC PA
Practice address
2546 Bee Ridge Rd
Sarasota, FL 34239-6413
Phone
(941) 925-2889
Fax
(941) 925-2889
NPI assigned
Jun 18, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2010

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

Authorized official

Name
Dr. Robert J Decubellis, DCNPI 1225192057
Title
Owner
Phone
(941) 925-2889

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NN1001X CH 5969 FL Primary

Addresses

Primary practice location

2546 Bee Ridge Rd
Sarasota, FL 34239-6413

Mailing address

2546 Bee Ridge Rd
Sarasota, FL 34239-6413
Phone (941) 925-2889

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100625000202 FL Part B Supplier - Clinic/Group Practice 6305977976 Receives reassigned benefits from 1 practitioner
Practice locations: Sarasota, FL

National Provider Directory

National Provider Directory

Locations

2546 Bee Ridge Rd
Sarasota, FL 34239
Phone (941) 925-2889

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1276819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276819200000",
    "number": "1447571906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2546 BEE RIDGE RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342396413",
            "telephone_number": "941-925-2889",
            "fax_number": "941-925-2889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2546 BEE RIDGE RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342396413",
            "telephone_number": "941-925-2889",
            "fax_number": "941-925-2889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT J DECUBELLIS DC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-18",
        "last_updated": "2010-06-18",
        "status": "A",
        "authorized_official_last_name": "DECUBELLIS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-925-2889",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "FL",
            "license": "CH 5969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.