Larissa Marie Tilley, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4404 Issued in OH

Practice address

4774 Munson St NW
Suite 302
Canton, OH 44718-3634

Phone

(330) 494-0422

Fax

(330) 494-3601

NPI assigned

Jan 25, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Larissa Marie Campitelli Former name

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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

• Ferguson Family Chiropractic and Wellness Center, LLC

  dba Brian P. Ferguson

  • Chiropractor
  • North Canton, OH
  • NPI 1174861496
  Medicare reassignment

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

{
    "created_epoch": "1327449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382400000000",
    "number": "1912278730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4774 MUNSON ST NW",
            "address_2": "SUITE 302",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183634",
            "telephone_number": "330-494-0422",
            "fax_number": "330-494-3601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4774 MUNSON ST NW",
            "address_2": "SUITE 302",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183634",
            "telephone_number": "330-494-0422",
            "fax_number": "330-494-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLEY",
        "first_name": "LARISSA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-25",
        "last_updated": "2013-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2012002407",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "2595",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "4404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARISSA",
            "last_name": "CAMPITELLI",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Flanda Tibbs
• Anna Marie Tice, PTA
• Maria Tickle
• Joan Tiefel
• Diana Jessie Tieger, PSYD
• Michele L Tilstra, OT
• Elizabeth Marie Timmers, MSW, LSW
• Jamie Timms, CT
• Timothy a Morris DDS Inc
• Tina M Cross Smothers

• Chiropractor in Canton, OH
• Providers in Canton, OH by specialty
• Chiropractor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.