Individual provider Active NPI

Marian L Vitali, D.C.

  • Chiropractor
  • Tolland, CT
National Provider Identifier
1730116559
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
795 Issued in CT
Practice address
68 Hartford Tpke
Tolland, CT 06084-2841
Phone
(860) 871-0451
Fax
(860) 875-3445
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 795 CT Primary

Addresses

Primary practice location

68 Hartford Tpke
Tolland, CT 06084-2841

Mailing address

68 Hartford Tpke
Tolland, CT 06084-2841
Phone (860) 871-0451

Other identifiers 1

IdentifierTypeStateIssuer
00411877600MedicaidCT

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
000795CTMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730116559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 HARTFORD TPKE",
            "city": "TOLLAND",
            "state": "CT",
            "postal_code": "060842841",
            "telephone_number": "860-871-0451",
            "fax_number": "860-875-3445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 HARTFORD TPKE",
            "city": "TOLLAND",
            "state": "CT",
            "postal_code": "060842841",
            "telephone_number": "860-871-0451",
            "fax_number": "860-875-3445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITALI",
        "first_name": "MARIAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00411877600",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tolland, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.