Individual provider Active NPI

Daniel Vern Velliquette, DC

  • Chiropractor
  • Fort Wayne, IN
National Provider Identifier
1962586685
Registry record updated Feb 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002059A Issued in IN
Practice address
971 Chestnut Hills Parkway
Fort Wayne, IN 46814
Phone
(260) 625-6511
Fax
(260) 625-6711
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08002059A IN Primary

Addresses

Primary practice location

971 Chestnut Hills Parkway
Fort Wayne, IN 46814

Mailing address

971 Chestnut Hills Parkway
Fort Wayne, IN 46814
Phone (260) 625-6511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101113000037 IN Practitioner - Chiropractic 4385638014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

971 Chestnut Hills Pkwy
Fort Wayne, IN 46814-8932
Phone (260) 625-6511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08002059AINMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chestnut Hills Chiropractic Center Chiropractor CurrentSince May 4, 2003 Accepting new patients

Locations

971 Chestnut Hills Pkwy
Fort Wayne, IN 46814
Phone (260) 435-1700

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203984000000",
    "number": "1962586685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971 CHESTNUT HILLS PARKWAY",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46814",
            "telephone_number": "260-625-6511",
            "fax_number": "260-625-6711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 CHESTNUT HILLS PARKWAY",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46814",
            "telephone_number": "260-625-6511",
            "fax_number": "260-625-6711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELLIQUETTE",
        "first_name": "DANIEL",
        "middle_name": "VERN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2008-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002059A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.