Individual provider Active NPI

Richard P. Muccillo, D.C.

  • Neurology Chiropractor
  • Carlsbad, CA
National Provider Identifier
1942420377
Registry record updated Dec 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
DC15102 Issued in CA
Practice address
800 Grand Ave
B-4
Carlsbad, CA 92008-1808
Phone
(760) 729-0047
Fax
(760) 729-0915
NPI assigned
Apr 26, 2007
Last updated
Dec 20, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X DC15102 CA Primary
Neurology Chiropractor 111NN0400X DC322 HI

Addresses

Primary practice location

800 Grand Ave
B-4
Carlsbad, CA 92008-1808

Mailing address

800 Grand Ave
B-4
Carlsbad, CA 92008-1808
Phone (760) 729-0047

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

State licenses

LicenseStateTypeSpecialty
DC15102CAMDNeurology Chiropractor
DC322HIMDNeurology Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
North County Acupuncture Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198108800000",
    "number": "1942420377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 GRAND AVE",
            "address_2": "B-4",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081808",
            "telephone_number": "760-729-0047",
            "fax_number": "760-729-0915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 GRAND AVE",
            "address_2": "B-4",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081808",
            "telephone_number": "760-729-0047",
            "fax_number": "760-729-0915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUCCILLO",
        "first_name": "RICHARD",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "CA",
            "license": "DC15102",
            "primary": true
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "HI",
            "license": "DC322",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.

Verify at the official NPI Registry.