Individual provider Active NPI

Patricia O'Brien, DC

  • Chiropractor
  • Stratford, NJ
National Provider Identifier
1023047495
Registry record updated May 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00419800 Issued in NJ
Practice address
321 Yale Ave
A
Stratford, NJ 08084-1247
Phone
(856) 782-7500
Fax
(856) 782-0075
NPI assigned
Jun 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00419800 NJ Primary

Addresses

Primary practice location

321 Yale Ave
A
Stratford, NJ 08084-1247

Mailing address

321 Yale Ave
A
Stratford, NJ 08084-1247
Phone (856) 782-7500

Other identifiers 6

IdentifierTypeStateIssuer
1037744OtherNJAMERICAN SPECALTY PIN
2364020OtherNJAETNA HMO
0151772000OtherNJAH, KEYSTN, PC GRP PIN
0207600000OtherNJAH, KEYSTN, PC INDIVD PIN
2632234OtherNJOXFORD PIN
11081097OtherNJCIGNA PIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050203000622 NJ Practitioner - Chiropractic 0143271445 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

321 Yale Ave
Suite a
Stratford, NJ 08084-1247
Phone (856) 782-7500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00419800NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Patricia C. O'Brien, PC Chiropractor CurrentSince Oct 6, 2009 Accepting new patients
Stratford Center for Spinal Health, LLC Chiropractor CurrentSince Sep 1, 2018 Accepting new patients
Dr. Robert O'Brien Chiropractor Past Accepting new patients

Locations

215 E Laurel Rd
Ste 203
Stratford, NJ 08084
Phone (609) 782-7500

321 Yale Ave
Ste A
Stratford, NJ 08084
Phone (856) 782-7500

Organizations & group practices 3

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335916800000",
    "number": "1023047495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 YALE AVE",
            "address_2": "A",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841247",
            "telephone_number": "856-782-7500",
            "fax_number": "856-782-0075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 YALE AVE",
            "address_2": "A",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841247",
            "telephone_number": "856-782-7500",
            "fax_number": "856-782-0075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "PATRICIA",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2012-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00419800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN SPECALTY PIN",
            "identifier": "1037744",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2364020",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AH, KEYSTN, PC GRP PIN",
            "identifier": "0151772000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AH, KEYSTN, PC INDIVD PIN",
            "identifier": "0207600000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD PIN",
            "identifier": "2632234",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PIN",
            "identifier": "11081097",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2012; 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.