Dermont Matarjaro Spell, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4289 Issued in SC

Practice address

130 Letourneu Circle BLDG 90311
Hurlburt Field, FL 52544-5613

Phone

(850) 881-4327

NPI assigned

Dec 31, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1262217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613347200000",
    "number": "1881924546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 LETOURNEU CIRCLE BLDG 90311",
            "city": "HURLBURT FIELD",
            "state": "FL",
            "postal_code": "525445613",
            "telephone_number": "850-881-4327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 LETOURNEU CIRCLE BLDG 90311",
            "city": "HURLBURT FIELD",
            "state": "FL",
            "postal_code": "525445613",
            "telephone_number": "850-881-4327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPELL",
        "first_name": "DERMONT",
        "middle_name": "MATARJARO",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-31",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC-27702",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "4289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Frances Smith, MPT, OCS
• Gemma I Sohn, LCSW-C
• Tatiana Margarita Soria, PSY.D.
• Jonathan James Sparks
• Sinead Catherine Specht
• Nicole Pukylo Spickerman, IDMT
• John M Spilker, RPH
• Amanda A Storvick, LPC
• Stephen M Stouder, PSY.D.
• Eric Stratoti

• Chiropractor in Hurlburt Field, FL
• Providers in Hurlburt Field, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2021; 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.