NPIMap

Organization Active NPI

John Longo

Doing business as Park Chiropractic Center, LLC

  • Chiropractor
  • Nutley, NJ
National Provider Identifier
1033411715
Registry record updated Dec 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00205200 Issued in NJ
Legal business name
JOHN LONGO
Doing business as
Park Chiropractic Center, LLC
Practice address
715 Bloomfield Ave
Nutley, NJ 07110-1021
Phone
(973) 661-2303
Fax
(973) 661-9141
NPI assigned
Dec 1, 2010
Last updated
Dec 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2010

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

Authorized official

Name
Dr. John Nicholas Longo, DCNPI 1225093263
Title
Owner
Phone
(973) 661-2303

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 38MC00205200 NJ Primary

Addresses

Primary practice location

715 Bloomfield Ave
Nutley, NJ 07110-1021

Mailing address

715 Bloomfield Ave
Nutley, NJ 07110-1021
Phone (973) 661-2303

Other identifiers 1

IdentifierTypeStateIssuer
1474103MedicaidNJ

Other names 1

  • Park Chiropractic Center, LLC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1291161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291161600000",
    "number": "1033411715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 BLOOMFIELD AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071101021",
            "telephone_number": "973-661-2303",
            "fax_number": "973-661-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 BLOOMFIELD AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071101021",
            "telephone_number": "973-661-2303",
            "fax_number": "973-661-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN LONGO",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-01",
        "last_updated": "2010-12-01",
        "status": "A",
        "authorized_official_last_name": "LONGO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "NICHOLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-661-2303",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00205200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1474103",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Chiropractic Center, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nutley, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2010; 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.