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  7. NPI Record 1770561490

DR. SHANNON MARINIELLO DC
Complete NPI Record 1770561490
Chiropractor in Garfield, NJ

NPI Status: Active since January 03, 2006

Contact Information

517 RIVER DR STE 2A
GARFIELD, NJ
ZIP 07026
Phone: (973) 955-0755
Fax: (973) 955-0753

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Name Prefix Text
  6. Provider Credential Text
  7. Provider First Line Business Mailing Address
  8. Provider Business Mailing Address City Name
  9. Provider Business Mailing Address State Name
  10. Provider Business Mailing Address Postal Code
  11. Provider Business Mailing Address Country Code If outside U S
  12. Provider Business Mailing Address Telephone Number
  13. Provider Business Mailing Address Fax Number
  14. Provider First Line Business Practice Location Address
  15. Provider Business Practice Location Address City Name
  16. Provider Business Practice Location Address State Name
  17. Provider Business Practice Location Address Postal Code
  18. Provider Business Practice Location Address Country Code If outside U S
  19. Provider Business Practice Location Address Telephone Number
  20. Provider Business Practice Location Address Fax Number
  21. Provider Enumeration Date
  22. Last Update Date
  23. Provider Gender Code
  24. Healthcare Provider Taxonomy Code 1
  25. Provider License Number 1
  26. Provider License Number State Code 1
  27. Healthcare Provider Primary Taxonomy Switch 1
  28. Other Provider Identifier 1
  29. Other Provider Identifier Type Code 1
  30. Other Provider Identifier State 1
  31. Other Provider Identifier Issuer 1
  32. Other Provider Identifier 2
  33. Other Provider Identifier Type Code 2
  34. Other Provider Identifier State 2
  35. Other Provider Identifier Issuer 2
  36. Other Provider Identifier 3
  37. Other Provider Identifier Type Code 3
  38. Other Provider Identifier State 3
  39. Other Provider Identifier Issuer 3
  40. Other Provider Identifier 4
  41. Other Provider Identifier Type Code 4
  42. Other Provider Identifier State 4
  43. Other Provider Identifier Issuer 4
  44. Other Provider Identifier 5
  45. Other Provider Identifier Type Code 5
  46. Other Provider Identifier State 5
  47. Other Provider Identifier 6
  48. Other Provider Identifier Type Code 6
  49. Other Provider Identifier State 6
  50. Other Provider Identifier Issuer 6
  51. Other Provider Identifier 7
  52. Other Provider Identifier Type Code 7
  53. Other Provider Identifier State 7
  54. Other Provider Identifier Issuer 7
  55. Other Provider Identifier 8
  56. Other Provider Identifier Type Code 8
  57. Other Provider Identifier State 8
  58. Other Provider Identifier Issuer 8
  59. Other Provider Identifier 9
  60. Other Provider Identifier Type Code 9
  61. Other Provider Identifier State 9
  62. Other Provider Identifier Issuer 9
  63. Other Provider Identifier 10
  64. Other Provider Identifier Type Code 10
  65. Other Provider Identifier State 10
  66. Other Provider Identifier Issuer 10
  67. Other Provider Identifier 11
  68. Other Provider Identifier Type Code 11
  69. Other Provider Identifier State 11
  70. Other Provider Identifier Issuer 11
  71. Other Provider Identifier 12
  72. Other Provider Identifier Type Code 12
  73. Other Provider Identifier State 12
  74. Other Provider Identifier Issuer 12
  75. Other Provider Identifier 13
  76. Other Provider Identifier Type Code 13
  77. Other Provider Identifier State 13
  78. Other Provider Identifier Issuer 13
  79. Other Provider Identifier 14
  80. Other Provider Identifier Type Code 14
  81. Other Provider Identifier State 14
  82. Other Provider Identifier Issuer 14
  83. Other Provider Identifier 15
  84. Other Provider Identifier Type Code 15
  85. Other Provider Identifier State 15
  86. Other Provider Identifier Issuer 15
  87. Is Sole Proprietor

Complete NPI Dataset

This page represents the complete record for NPI 1770561490. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1770561490
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: SHANNON
The first name of the provider, if the provider is an individual.
Provider Name Prefix Text: DR.
The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Credential Text: DC
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address: 517 RIVER DR STE 2A
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: GARFIELD
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: NJ
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 070263270
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 9739550755
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 9739550753
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: 517 RIVER DR STE 2A
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: GARFIELD
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: NJ
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 070263270
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 9739550755
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 9739550753
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 1/3/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 7/21/2022
The date that a record was last updated or changed.
Provider Gender Code: M
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 111N00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 38MC00505700
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: NJ
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: Y
Other Provider Identifier 1: 1126013
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1: NJ
Other Provider Identifier Issuer 1: HORIZON NJ HEALTH
Other Provider Identifier 2: 31356
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 2: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 2: NJ
Other Provider Identifier Issuer 2: MASTERCARE
Other Provider Identifier 3: 5362694
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 3: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 3: NJ
Other Provider Identifier Issuer 3: AETNA
Other Provider Identifier 4: 5899591
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 4: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 4: NJ
Other Provider Identifier Issuer 4: GHI
Other Provider Identifier 5: 7722702
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 5: 05
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 5: NJ
Other Provider Identifier 6: 0798375000
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 6: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 6: NJ
Other Provider Identifier Issuer 6: AMERIHEALTH
Other Provider Identifier 7: 1996718
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 7: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 7: NJ
Other Provider Identifier Issuer 7: UNITED HEALTHCARE
Other Provider Identifier 8: 1047999
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 8: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 8: NJ
Other Provider Identifier Issuer 8: AETNA HMO
Other Provider Identifier 9: 050005057NJ01
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 9: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 9: NJ
Other Provider Identifier Issuer 9: ANTHEM HEALTH
Other Provider Identifier 10: 24878
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 10: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 10: NJ
Other Provider Identifier Issuer 10: UNIVERSITY HEALTH PLANS
Other Provider Identifier 11: X2D241
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 11: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 11: NJ
Other Provider Identifier Issuer 11: EMPIRE
Other Provider Identifier 12: 96301
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 12: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 12: NJ
Other Provider Identifier Issuer 12: AMERIGROUP
Other Provider Identifier 13: P2084184
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 13: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 13: NJ
Other Provider Identifier Issuer 13: OXFORD
Other Provider Identifier 14: 5362694
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 14: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 14: NJ
Other Provider Identifier Issuer 14: AETNA PPO
Other Provider Identifier 15: 5936399004
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 15: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 15: NJ
Other Provider Identifier Issuer 15: CIGNA
Is Sole Proprietor: Y
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No