Active NPI
Michael L Tomasello Jr., D.C.
- Chiropractor
- Marietta, GA
National Provider Identifier
1700807930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHIR005275
- Practice address
- 1415 Barclay Cir SE
Marietta, GA 30060-2943 - Phone
- (770) 426-2786
- Fax
- (770) 792-6113
- NPI assigned
- Jul 22, 2006
- 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 | CHIR005275 | GA | Primary |
Addresses
Primary practice location
1415 Barclay Cir SE
Marietta, GA 30060-2943
Mailing address
1415 Barclay Cir SE
Marietta, GA 30060-2943
Phone (770) 426-2786
Other practice location 1
2000 Powers Ferry Rd SE
Suite 1-10
Marietta, GA 30067-9476
Phone (770) 859-9579
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHIR005275 | GA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hoopinsocker Incorporated | Chiropractor | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Chiropractor
- Kennesaw, GA
- NPI 1609090034
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617840000000",
"number": "1700807930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1415 BARCLAY CIR SE",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300602943",
"telephone_number": "770-426-2786",
"fax_number": "770-792-6113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1415 BARCLAY CIR SE",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300602943",
"telephone_number": "770-426-2786",
"fax_number": "770-792-6113"
}
],
"practiceLocations": [
{
"address_1": "2000 Powers Ferry Rd SE",
"address_2": "SUITE 1-10",
"address_purpose": "LOCATION",
"city": "Marietta",
"state": "GA",
"postal_code": "300679476",
"country_code": "US",
"telephone_number": "770-859-9579",
"fax_number": "770-859-9299",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TOMASELLO",
"first_name": "MICHAEL",
"middle_name": "L",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-22",
"last_updated": "2021-04-08",
"certification_date": "2021-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "GA",
"license": "CHIR005275",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.