Individual provider Active NPI

Charles Anthony Paolantonio, D.C.

  • Sports Physician Chiropractor
  • North Ferrisburgh, VT
National Provider Identifier
1649369216
Registry record updated Mar 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
006-0000623 Issued in VT
Practice address
381 Morgan Rd
North Ferrisburgh, VT 05473-9750
Phone
(802) 388-3033
NPI assigned
Oct 12, 2006
Last updated
Mar 3, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 006-0000623 VT Primary

Addresses

Primary practice location

381 Morgan Rd
North Ferrisburgh, VT 05473-9750

Mailing address

381 Morgan Rd
North Ferrisburgh, VT 05473-9750
Phone (802) 425-3625

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040908000218 VT Practitioner - Chiropractic 3779559190 Practice locations: Shelburne, VT

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

145 Pine Haven Shores Rd
Suite 1153
Shelburne, VT 05482-7703
Phone (802) 417-9286

166 Athletic Dr
Shelburne, VT 05482-4433
Phone (802) 985-4460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006-0000623VTMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Chiropractic & Kinesiology Past Accepting new patients
Dee Physical Therapy Services PLC PastSince Jul 11, 2012 Accepting new patients

Organizations & group practices 2

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520035200000",
    "number": "1649369216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "381 MORGAN RD",
            "city": "NORTH FERRISBURGH",
            "state": "VT",
            "postal_code": "054739750",
            "telephone_number": "802-425-3625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "381 MORGAN RD",
            "city": "NORTH FERRISBURGH",
            "state": "VT",
            "postal_code": "054739750",
            "telephone_number": "802-388-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAOLANTONIO",
        "first_name": "CHARLES",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2018-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "VT",
            "license": "006-0000623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Ferrisburgh, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2018; 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.