Individual provider Active NPI

Thomas William Petrisko, DC

  • Chiropractor
  • McKees Rocks, PA
National Provider Identifier
1952464067
Registry record updated May 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC002430-L Issued in PA
Practice address
6091 Steubenville Pike
MC Kees Rocks, PA 15136-1336
Phone
(412) 787-3320
Fax
(412) 494-9579
NPI assigned
Dec 19, 2006
Last updated
May 21, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC002430-L PA Primary

Addresses

Primary practice location

6091 Steubenville Pike
MC Kees Rocks, PA 15136-1336

Mailing address

6091 Steubenville Pike
MC Kees Rocks, PA 15136-1336
Phone (412) 787-3320

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
DC002430-LPAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Chiropractic Centers, Inc. Chiropractor Past Accepting new patients
Family Chiropractic Center of Pittsburgh, LLC Chiropractor Past Accepting new patients

Organizations & group practices 2

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": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242864000000",
    "number": "1952464067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6091 STEUBENVILLE PIKE",
            "city": "MC KEES ROCKS",
            "state": "PA",
            "postal_code": "151361336",
            "telephone_number": "412-787-3320",
            "fax_number": "412-494-9579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6091 STEUBENVILLE PIKE",
            "city": "MC KEES ROCKS",
            "state": "PA",
            "postal_code": "151361336",
            "telephone_number": "412-787-3320",
            "fax_number": "412-494-9579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRISKO",
        "first_name": "THOMAS",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2009-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC002430-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKees Rocks, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2009; 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.