Active NPI
Shannon Mariniello, DC
- Chiropractor
- Garfield, NJ
National Provider Identifier
1770561490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 38MC00505700
- Practice address
- 517 River Dr Ste 2a
Garfield, NJ 07026-3270 - Phone
- (973) 955-0755
- Fax
- (973) 955-0753
- NPI assigned
- Jan 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | 38MC00505700 | NJ | Primary |
Addresses
Primary practice location
517 River Dr Ste 2a
Garfield, NJ 07026-3270
Mailing address
517 River Dr Ste 2a
Garfield, NJ 07026-3270
Phone (973) 955-0755
Other practice location 1
227 Market St
Elmwood Park, NJ 07407-2009
Phone (201) 797-2554
Other identifiers 15
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1996718 | Other | NJ | UNITED HEALTHCARE |
| 31356 | Other | NJ | MASTERCARE |
| 5899591 | Other | NJ | GHI |
| 5936399004 | Other | NJ | CIGNA |
| X2D241 | Other | NJ | EMPIRE |
| 1047999 | Other | NJ | AETNA HMO |
| 050005057NJ01 | Other | NJ | ANTHEM HEALTH |
| 0798375000 | Other | NJ | AMERIHEALTH |
| 96301 | Other | NJ | AMERIGROUP |
| 1126013 | Other | NJ | HORIZON NJ HEALTH |
| 5362694 | Other | NJ | AETNA |
| 5362694 | Other | NJ | AETNA PPO |
| 7722702 | Medicaid | NJ | |
| 24878 | Other | NJ | UNIVERSITY HEALTH PLANS |
| P2084184 | Other | NJ | OXFORD |
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 |
|---|---|---|---|
| 38MC00505700 | NJ | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1770561490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "517 RIVER DR STE 2A",
"city": "GARFIELD",
"state": "NJ",
"postal_code": "070263270",
"telephone_number": "973-955-0755",
"fax_number": "973-955-0753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "517 RIVER DR STE 2A",
"city": "GARFIELD",
"state": "NJ",
"postal_code": "070263270",
"telephone_number": "973-955-0755",
"fax_number": "973-955-0753"
}
],
"practiceLocations": [
{
"address_1": "227 Market St",
"address_purpose": "LOCATION",
"city": "Elmwood Park",
"state": "NJ",
"postal_code": "074072009",
"country_code": "US",
"telephone_number": "201-797-2554",
"fax_number": "201-794-9244",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARINIELLO",
"first_name": "SHANNON",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-03",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NJ",
"license": "38MC00505700",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "1996718",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASTERCARE",
"identifier": "31356",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "5899591",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "5936399004",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE",
"identifier": "X2D241",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "1047999",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM HEALTH",
"identifier": "050005057NJ01",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH",
"identifier": "0798375000",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "96301",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HORIZON NJ HEALTH",
"identifier": "1126013",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5362694",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO",
"identifier": "5362694",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7722702",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNIVERSITY HEALTH PLANS",
"identifier": "24878",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P2084184",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Garfield, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.