Individual provider Active NPI

Michael Simon Hendley, DC

  • Chiropractor
  • Somers Point, NJ
National Provider Identifier
1003914623
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00639900 Issued in NJ
Practice address
52 E New York Ave
Somers Point, NJ 08244-2380
Phone
(609) 788-3539
Fax
(609) 788-3582
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00639900 NJ Primary

Addresses

Primary practice location

52 E New York Ave
Somers Point, NJ 08244-2380

Mailing address

20 N Aberdeen PL
Atlantic City, NJ 08401-3302
Phone (609) 348-3319

Other identifiers 3

IdentifierTypeStateIssuer
0102296MedicaidNJ
2724753000OtherNJAMERIHEALTH
010853392OtherNJBLUE CROSS/BLUE SHIELD

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

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003914623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 N ABERDEEN PL",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084013302",
            "telephone_number": "609-348-3319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 E NEW YORK AVE",
            "city": "SOMERS POINT",
            "state": "NJ",
            "postal_code": "082442380",
            "telephone_number": "609-788-3539",
            "fax_number": "609-788-3582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDLEY",
        "first_name": "MICHAEL",
        "middle_name": "SIMON",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00639900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0102296",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "2724753000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "010853392",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somers Point, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.