Individual provider Active NPI

Maryjoyce Rotella, DC, LAC

  • Chiropractor
  • Burtonsville, MD
National Provider Identifier
1710156724
Registry record updated Sep 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S03750 Issued in MD
Practice address
15891 Kruhm Rd
Burtonsville, MD 20866-1411
Phone
(301) 421-4248
NPI assigned
Feb 23, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 009359 PA
Acupuncturist 171100000X OM000042 PA
Chiropractor 111N00000X S03750 MD Primary
Acupuncturist 171100000X U02035 MD

Addresses

Primary practice location

15891 Kruhm Rd
Burtonsville, MD 20866-1411

Mailing address

15891 Kruhm Rd
Burtonsville, MD 20866-1411
Phone (301) 421-4248

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

LicenseStateTypeSpecialty
S03750MDMDChiropractor
009359PAMDChiropractor
U02035MDMDAcupuncturist
OM000042PAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1203724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410220800000",
    "number": "1710156724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15891 KRUHM RD",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208661411",
            "telephone_number": "301-421-4248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15891 KRUHM RD",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208661411",
            "telephone_number": "301-421-4248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTELLA",
        "first_name": "MARYJOYCE",
        "name_prefix": "Dr.",
        "credential": "DC, LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-23",
        "last_updated": "2014-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "009359",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "PA",
            "license": "OM000042",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S03750",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MD",
            "license": "U02035",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burtonsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.