High Street Rehab, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

MC02501 Issued in NJ

Legal business name

HIGH STREET REHAB, LLC

Practice address

25 High St
Nutley, NJ 07110-1131

Phone

(973) 235-1515

Fax

(973) 235-0452

NPI assigned

Dec 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Steven Clarke, D.C.NPI 1477674836

Title

Chiropractor/Owner

Phone

(973) 235-1515

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steven G Clarke, DC

  • Chiropractor
  • Nutley, NJ
  • NPI 1477674836
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1053593616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 HIGH ST",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071101131",
            "telephone_number": "973-235-1515",
            "fax_number": "973-235-0452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 HIGH ST",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071101131",
            "telephone_number": "973-235-1515",
            "fax_number": "973-235-0452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGH STREET REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "973-235-1515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "MC02501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kimberly Marie Hollywood, DMD
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• Chiropractor in Nutley, NJ
• Providers in Nutley, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.