Peter William Vercellino, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038.013325 Issued in IL

Practice address

3350 N Water St Ste a
Decatur, IL 62526-2353

Phone

(217) 877-2404

Fax

(217) 877-2522

NPI assigned

Feb 28, 2019

Sex

Male

Sole proprietor

No

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

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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.

• Vercellino Purchasing Co

  • Chiropractor
  • Decatur, IL
  • NPI 1881152288
  Medicare reassignment NPD Authorized official
• Mario Fucinari DC LLC

  • Chiropractor
  • Decatur, IL
  • NPI 1780853119
  NPD

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

{
    "created_epoch": "1551312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1619434388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 N 33RD ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625212314",
            "telephone_number": "217-520-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 N WATER ST STE A",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625262353",
            "telephone_number": "217-877-2404",
            "fax_number": "217-877-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERCELLINO",
        "first_name": "PETER",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-28",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.013325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mario R Velasco, MD
• Mylee Deann Venters
• Christina Elizabeth Ventimiglia-Brandt, FNP-BC
• Kenneth Veon, LCPC CADC
• Vercellino Purchasing Co
• Margaret Verklan
• Ajay Verma, MD
• Kasun Chamara Vernon, MD
• Vero Clinics Inc
• Veteran'S Administration

• Chiropractor in Decatur, IL
• Providers in Decatur, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; 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.