Organization Active NPI

Innate Wisdom LLC

Doing business as The Back Pain Center

  • Chiropractor
  • New York, NY
National Provider Identifier
1023463205
Registry record updated Sep 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X011990-1 Issued in NY
Legal business name
INNATE WISDOM LLC
Doing business as
The Back Pain Center
Practice address
290 Madison Ave
Sixth Floor
New York, NY 10017-6308
Phone
(212) 725-0755
Fax
(212) 725-0577
NPI assigned
Apr 26, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2016

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

Authorized official

Name
Dr. Dennis James Barteck, D.C.
Title
Ceo/Owner
Phone
(212) 725-0755

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X X011990-1 NY Primary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 38MC00498700 NJ

Addresses

Primary practice location

290 Madison Ave
Sixth Floor
New York, NY 10017-6308

Mailing address

1550 Harbor Blvd
Apt 2511
Weehawken, NJ 07086
Phone (212) 725-0755

Other identifiers 1

IdentifierTypeStateIssuer
1396785499OtherNYNPI

Other names 1

  • The Back Pain Center Doing business as

National Provider Directory

National Provider Directory

Locations

290 Madison Ave
Fl 6
New York, NY 10017
Phone (212) 679-4960

NPI Registry JSON

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474934400000",
    "number": "1023463205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 HARBOR BLVD",
            "address_2": "APT 2511",
            "city": "WEEHAWKEN",
            "state": "NJ",
            "postal_code": "07086",
            "telephone_number": "212-725-0755",
            "fax_number": "212-725-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 MADISON AVE",
            "address_2": "SIXTH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176308",
            "telephone_number": "212-725-0755",
            "fax_number": "212-725-0577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNATE WISDOM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-26",
        "last_updated": "2016-09-27",
        "status": "A",
        "authorized_official_last_name": "BARTECK",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "212-725-0755",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X011990-1",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00498700",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1396785499",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Back Pain Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2016; 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.