Individual provider Active NPI

Donna Pontrello, D.C.

  • Chiropractor
  • Petaluma, CA
National Provider Identifier
1457545089
Registry record updated Aug 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
30083 Issued in CA
Practice address
1112 B St
Petaluma, CA 94952-4054
Phone
(707) 888-9568
NPI assigned
Aug 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 30083 CA Primary

Addresses

Primary practice location

1112 B St
Petaluma, CA 94952-4054

Mailing address

1112 B St
Petaluma, CA 94952-4054
Phone (707) 888-9568

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

State licenses

LicenseStateTypeSpecialty
1750NMMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlas Orthogonal Chiropractic of Albuquerque LLC Chiropractor Past Accepting new patients
Amundsen, Inc. Chiropractor PastSince Jul 24, 2022 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188172800000",
    "number": "1457545089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 B ST",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949524054",
            "telephone_number": "707-888-9568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 B ST",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949524054",
            "telephone_number": "707-888-9568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONTRELLO",
        "first_name": "DONNA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-27",
        "last_updated": "2007-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "30083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petaluma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.

Verify at the official NPI Registry.