Ronald J. Pellicani, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3616 Issued in SC

Practice address

568 George Bishop Pkwy
Myrtle Beach, SC 29579-7339

Phone

(843) 236-2200

NPI assigned

Sep 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Davis Square Chiropractic, PC

  • Chiropractor
  • Somerville, MA
  • NPI 1710251632
  NPD

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1558462887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4016 RIVER OAKS DR # 149",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295796673",
            "telephone_number": "843-236-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "568 GEORGE BISHOP PKWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295797339",
            "telephone_number": "843-236-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLICANI",
        "first_name": "RONALD",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "1610",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1610082",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH PLAN",
            "identifier": "994529",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH3616",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF MA",
            "identifier": "Y36167",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "181432",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0014298",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeremy Pearce, FNP-C
• Andrew N Pearson, MD
• Yelena Pecheny
• Sandra Peeler, CLTC
• Kathryn Rae Peelish, DO
• Katelyn Pena
• Lorela Pengu
• Nyree M Penn, AA-C
• Stephen Andrew Pentheros, NP
• Antonio P Pepe, M.D

• Chiropractor in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; 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.