Individual provider Active NPI

John M Bomhoff, DC

  • Chiropractor
  • Cedar Grove, NJ
National Provider Identifier
1013128131
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00459400 Issued in NJ
Practice address
411 Pompton Ave
Cedar Grove, NJ 07009-1800
Phone
(973) 239-3222
Fax
(973) 239-4644
NPI assigned
May 24, 2007
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 38MC00459400 NJ Primary

Addresses

Primary practice location

411 Pompton Ave
Cedar Grove, NJ 07009-1800

Mailing address

58 Round Hill Rd
Kinnelon, NJ 07405-3219
Phone (973) 838-5963

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
38MC00459400NJMDChiropractor
4594NJMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013128131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 ROUND HILL RD",
            "city": "KINNELON",
            "state": "NJ",
            "postal_code": "074053219",
            "telephone_number": "973-838-5963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 POMPTON AVE",
            "city": "CEDAR GROVE",
            "state": "NJ",
            "postal_code": "070091800",
            "telephone_number": "973-239-3222",
            "fax_number": "973-239-4644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMHOFF",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00459400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Grove, 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.