Active NPI
William O Martin, D.C.
- Chiropractor
- Fanwood, NJ
National Provider Identifier
1043430234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 38MC00131300
- Practice address
- 141 South Ave
Suite #3
Fanwood, NJ 07023-1225 - Phone
- (908) 322-7400
- Fax
- (908) 322-7401
- NPI assigned
- Apr 27, 2007
- Last updated
- Oct 21, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 38MC00131300 | NJ | Primary |
Addresses
Primary practice location
141 South Ave
Suite #3
Fanwood, NJ 07023-1225
Mailing address
141 South Ave
Suite #3
Fanwood, NJ 07023-1225
Phone (908) 322-7400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090728000785 | NJ | Practitioner - Chiropractic | 3476606195 | Practice locations: Fanwood, NJ |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Columbia Institute Chiropractic, 1971
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
141 S Ave
Fanwood, NJ 07023-1225
Phone (908) 322-7400
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38MC00131300 | NJ | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224547200000",
"number": "1043430234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 SOUTH AVE",
"address_2": "SUITE #3",
"city": "FANWOOD",
"state": "NJ",
"postal_code": "070231225",
"telephone_number": "908-322-7400",
"fax_number": "908-322-7401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "141 SOUTH AVE",
"address_2": "SUITE #3",
"city": "FANWOOD",
"state": "NJ",
"postal_code": "070231225",
"telephone_number": "908-322-7400",
"fax_number": "908-322-7401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "WILLIAM",
"middle_name": "O",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-27",
"last_updated": "2008-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NJ",
"license": "38MC00131300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fanwood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; 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.