Individual provider Active NPI

Michael David Ville, DC

  • Orthopedic Chiropractor
  • Satellite Beach, FL
National Provider Identifier
1497883227
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
CH3794 Issued in FL
Practice address
155 Jackson Ave
Satellite Beach, FL 32937-2993
Phone
(321) 777-3677
Fax
(321) 779-8344
NPI assigned
Mar 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Chiropractor 111NX0800X CH3794 FL Primary

Addresses

Primary practice location

155 Jackson Ave
Satellite Beach, FL 32937-2993

Mailing address

155 Jackson Ave
Satellite Beach, FL 32937-2993
Phone (321) 777-3677

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040714000378 FL Practitioner - Chiropractic 9739168865 Reassigns benefits to 1 organization
Practice locations: Satellite Beach, FL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1981
Medicare assignment
May accept Medicare assignment
Group practices
Regenerative Spine and Body ClinicGroup PAC ID 9436464138, 2 clinicians

Practice addresses (Care Compare)

155 Jackson Ave
Suite C
Satellite Beach, FL 32937-2993
Phone (321) 773-2663

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Regenerative Spine and Body Clinic Orthopedic CurrentSince Dec 2, 2014 Accepting new patients

Locations

155 Jackson Ave
Satellite Beach, FL 32937
Phone (321) 773-2663

155 Jackson Ave
Ste C
Satellite Beach, FL 32937
Phone (321) 773-2663

Organizations & group practices 1

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": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497883227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 JACKSON AVE",
            "city": "SATELLITE BEACH",
            "state": "FL",
            "postal_code": "329372993",
            "telephone_number": "321-777-3677",
            "fax_number": "321-779-8344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 JACKSON AVE",
            "city": "SATELLITE BEACH",
            "state": "FL",
            "postal_code": "329372993",
            "telephone_number": "321-777-3677",
            "fax_number": "321-779-8344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLE",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "FL",
            "license": "CH3794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Satellite Beach, FL

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.
  • 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.