Michael J Pettella, DC, PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH0006496 Issued in FL

Legal business name

MICHAEL J PETTELLA, DC, PLLC

Practice address

6175 SE 126TH LN
Belleview, FL 34420-5208

Phone

(352) 245-8300

NPI assigned

May 13, 2010

Organization subpart

No

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

Authorized official

Name

Michael Pettella, DCNPI 1043200140

Title

President

Phone

(352) 245-8300

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael J Pettella, DC

  • Chiropractor
  • Belleview, FL
  • NPI 1043200140
  NPD (past) Authorized official

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

{
    "created_epoch": "1273708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273708800000",
    "number": "1891013900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6175 SE 126TH LN",
            "city": "BELLEVIEW",
            "state": "FL",
            "postal_code": "344205208",
            "telephone_number": "352-245-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6175 SE 126TH LN",
            "city": "BELLEVIEW",
            "state": "FL",
            "postal_code": "344205208",
            "telephone_number": "352-245-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J PETTELLA, DC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-13",
        "last_updated": "2010-05-13",
        "status": "A",
        "authorized_official_last_name": "PETTELLA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-245-8300",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0006496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350052194",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chris W McKenney, DC
• Dirika McNair
• Ingrid Luz Medina, DDS
• Nansi Medina
• Cindy Marlene Merritt, RPH
• Jessica Marie Miller
• Micayla Mills
• Rebekah Mogg
• Evyanette Montalvo-Rodriguez
• Breanna Taylor Moody

• Chiropractor in Belleview, FL
• Providers in Belleview, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2010; 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.