Glen Maricelli, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHI-CHI-LIC-6766 Issued in MT

Practice address

2330 S Higgins Ave Ste 100
Missoula, MT 59801-6923

Phone

(406) 728-0222

NPI assigned

Apr 29, 2021

Last updated

Apr 29, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clearwater Chiropractic PC

  • Chiropractor
  • Missoula, MT
  • NPI 1013658566
  Medicare reassignment NPD Authorized official
• Chiropractic Works Inc.

  • Chiropractor
  • Missoula, MT
  • NPI 1184989972
  Medicare reassignment NPD

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1790368645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 S HIGGINS AVE STE 100",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598016923",
            "telephone_number": "406-728-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 S HIGGINS AVE STE 100",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598016923",
            "telephone_number": "406-728-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARICELLI",
        "first_name": "GLEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-29",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MT",
            "license": "CHI-CHI-LIC-6766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Rose Mansch, M.D.
• Nicholas Alan Mantini
• Mapg, P.C. (Advanced Pain & Spine Institute of Montana, PC)
• Jenna Marceau, MSW
• Sarah Abigail Mardikian, PA-C
• Jennifer Maricelli, HHP,RMA
• Kelsie Maricelli, SLP
• Steven Marincel, MD
• Kirsten Marion, DNP, APRN
• Ashley Marjanen

• Chiropractor in Missoula, MT
• Providers in Missoula, MT by specialty
• Chiropractor in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.