Individual provider Active NPI

Russell J. Flacco, DC

  • Chiropractor
  • Doylestown, PA
National Provider Identifier
1871606111
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC001396L Issued in PA
Practice address
252 W Swamp Rd
Unit 57
Doylestown, PA 18901-2465
Phone
(215) 348-9551
Fax
(215) 345-9078
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC001396L PA Primary

Addresses

Primary practice location

252 W Swamp Rd
Unit 57
Doylestown, PA 18901-2465

Mailing address

252 W Swamp Rd
Unit 57
Doylestown, PA 18901-2465
Phone (215) 348-9551

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060825000351 PA Practitioner - Chiropractic 7810991213 Practice locations: Doylestown, PA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1972
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

252 W Swamp Rd
Doylestown, PA 18901-2465
Phone (215) 345-9078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1871606111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 W SWAMP RD",
            "address_2": "UNIT 57",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189012465",
            "telephone_number": "215-348-9551",
            "fax_number": "215-345-9078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 W SWAMP RD",
            "address_2": "UNIT 57",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189012465",
            "telephone_number": "215-348-9551",
            "fax_number": "215-345-9078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLACCO",
        "first_name": "RUSSELL",
        "middle_name": "J.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC001396L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doylestown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.