Joseph David Pelicano, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5104 Issued in SC

Practice address

6 Sevier St
Greenville, SC 29605

Phone

(864) 214-6163

NPI assigned

Aug 8, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Chiropractic

Education

Sherman College of Straight Chiropractic, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Form X Function Wellness, LLC

  • Chiropractor
  • Greenville, SC
  • NPI 1356178271
  NPD Authorized official

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

{
    "created_epoch": "1723075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1609607100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 PEACH GROVE PL",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "296623406",
            "telephone_number": "864-293-4213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 SEVIER ST",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "29605",
            "telephone_number": "864-214-6163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELICANO",
        "first_name": "JOSEPH",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-08",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "5104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pelham Community Healthcare LLC
• Pelham Family Practice LLC
• Pelham Oaks Dental
• Pelham Road Pharmacy Inc
• Pelham Road Pharmacy Inc
• Kimberly Pelicano
• Sara Colleen Pelikan-Cato, BCBA
• Sandra Lynn Pelisek, CRNA
• Maria M Pellegrino, CRNA
• Abigail Pellett, DPT

• Chiropractor in Greenville, SC
• Providers in Greenville, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.