Active NPI
Michael Stephen Petteruto, DC
- Chiropractor
- Coventry, RI
National Provider Identifier
1891740205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DCP00383
- Practice address
- 234 Chaplin Dr
Coventry, RI 02816 - Phone
- (401) 392-3351
- Fax
- (401) 392-3051
- NPI assigned
- May 24, 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 | DCP00383 | RI | Primary |
Addresses
Primary practice location
234 Chaplin Dr
Coventry, RI 02816
Mailing address
234 Chaplin Dr
Coventry, RI 02816
Phone (401) 392-3351
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6152953 | Other | RI | CIGNA |
| 21331430 | Other | RI | AETNA |
| 404806 | Other | RI | BLUE CHIP |
| 2822-8 | Other | RI | BLUE CROSS |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891740205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "234 CHAPLIN DR",
"city": "COVENTRY",
"state": "RI",
"postal_code": "02816",
"telephone_number": "401-392-3351",
"fax_number": "401-392-3051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "234 CHAPLIN DR",
"city": "COVENTRY",
"state": "RI",
"postal_code": "02816",
"telephone_number": "401-392-3351",
"fax_number": "401-392-3051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTERUTO",
"first_name": "MICHAEL",
"middle_name": "STEPHEN",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "RI",
"license": "DCP00383",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "6152953",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "21331430",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHIP",
"identifier": "404806",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "2822-8",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coventry, RI
- Pawtuxet Valley Prescription & Surgical Center,Inc
- Pawtuxet Valley Prescription & Surgical Center,Inc
- Pawtuxet Valley Prescription & Surgical Center,Inc
- Jocelyn Pearson
- Amy D Petrangelo, PT
- Steven Raymond Pezzullo, M.D
- Kerri Lee Pierce
- Jennifer Platt, PA
- Premier Care Dentistry of Rhode Island LLC
- Preventure, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.