Active NPI
Joseph Edward Petrella, DC
- Chiropractor
- Bentonville, AR
National Provider Identifier
1649002213
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 16393
- Practice address
- 2308 SE 28TH St Ste 8
Bentonville, AR 72712-3701 - Phone
- (479) 250-9834
- NPI assigned
- Aug 14, 2024
- Last updated
- Dec 20, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 16393 | AR | Primary |
Addresses
Primary practice location
2308 SE 28TH St Ste 8
Bentonville, AR 72712-3701
Mailing address
615 N 4TH St
Rogers, AR 72756-3609
Phone (918) 851-7933
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16393 | AR | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reform Chiropractic PLLC | Chiropractor | Current | Accepting new patients |
Locations
2308 SE 28th St
Ste 8
Bentonville, AR 72712
Phone (479) 250-9834
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734652800000",
"number": "1649002213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 N 4TH ST",
"city": "ROGERS",
"state": "AR",
"postal_code": "727563609",
"telephone_number": "918-851-7933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2308 SE 28TH ST STE 8",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727123701",
"telephone_number": "479-250-9834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRELLA",
"first_name": "JOSEPH",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-08-14",
"last_updated": "2024-12-20",
"certification_date": "2024-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AR",
"license": "16393",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bentonville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.