Individual provider Active NPI

Ronald T. Merriel Jr., D.C.

  • Chiropractor
  • Philadelphia, PA
National Provider Identifier
1760479232
Registry record updated Mar 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC007899L Issued in PA
Practice address
3502 Scotts LN
A-13
Philadelphia, PA 19129-1561
Phone
(215) 844-8484
Fax
(215) 933-5232
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC007899L PA Primary
Chiropractor 111N00000X 38MC00579500 NJ

Addresses

Primary practice location

3502 Scotts LN
A-13
Philadelphia, PA 19129-1561

Mailing address

205 Lincoln Ave
West Collingswood Heights, NJ 08059-1917
Phone (856) 979-3224

Other identifiers 5

IdentifierTypeStateIssuer
2006425000OtherBC/BS HMO
3818143OtherAETNA HMO
N13471OtherAMERIHEALTH
7269397OtherAETNA PPO
13888OtherELDERHEALTH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231114003757 CA Practitioner - Chiropractic 9638135114 Reassigns benefits to 1 organization
Practice locations: San Diego, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Jordan DC Greenlight Chiropractic Lake Forest Ca PCGroup PAC ID 3274988092, 2 clinicians

Practice addresses (Care Compare)

23101 Lake Ctr Dr
Suite 110
Lake Forest, CA 92630-2882
Phone (949) 586-2731

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00579500NJMDChiropractor
DC007899LPAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Jordan DC Greenlight Chiropractic Lake Forest Ca PC CurrentSince Dec 1, 2024 Accepting new patients
Regional Foot and Ankle Specialists, LLC Past Accepting new patients
Better Health Wellness, LLC PastSince Jan 8, 2019 Accepting new patients

Locations

23101 Lake Center Dr
Ste 110
Lake Forest, CA 92630
Phone (949) 586-2730

11828 Rancho Bernardo Rd
San Diego, CA 92128

11828 Rancho Bernardo Rd
Ste 205
San Diego, CA 92128
Phone (858) 485-8220

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395100800000",
    "number": "1760479232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 LINCOLN AVE",
            "city": "WEST COLLINGSWOOD HEIGHTS",
            "state": "NJ",
            "postal_code": "080591917",
            "telephone_number": "856-979-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 SCOTTS LN",
            "address_2": "A-13",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291561",
            "telephone_number": "215-844-8484",
            "fax_number": "215-933-5232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRIEL",
        "first_name": "RONALD",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2014-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC007899L",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00579500",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS HMO",
            "identifier": "2006425000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3818143",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "N13471",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7269397",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ELDERHEALTH",
            "identifier": "13888",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; 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.