Individual provider Active NPI

Michael J Funicello, DC

  • Chiropractor
  • Gilbert, AZ
National Provider Identifier
1457464158
Registry record updated Feb 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5765 Issued in AZ
Practice address
1757 E Baseline Rd Ste 114
Gilbert, AZ 85233-1533
Phone
(480) 558-1560
NPI assigned
Aug 16, 2006
Last updated
Feb 5, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5765 AZ Primary

Addresses

Primary practice location

1757 E Baseline Rd Ste 114
Gilbert, AZ 85233-1533

Mailing address

3860 S Marigold Way
Gilbert, AZ 85297-8899
Phone (480) 558-1560

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202169600000",
    "number": "1457464158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 S MARIGOLD WAY",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852978899",
            "telephone_number": "480-558-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1757 E BASELINE RD STE 114",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852331533",
            "telephone_number": "480-558-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNICELLO",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2008-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "5765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; 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.