Individual provider Active NPI

Eileen McGough, D.C.

  • Chiropractor
  • Freehold, NJ
National Provider Identifier
1063503092
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MCO3315 Issued in NJ
Practice address
124 W Main St
Freehold, NJ 07728-2049
Phone
(732) 462-6686
Fax
(732) 462-5512
NPI assigned
Sep 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X MCO3315 NJ Primary

Addresses

Primary practice location

124 W Main St
Freehold, NJ 07728-2049

Mailing address

124 W Main St
Freehold, NJ 07728-2049
Phone (732) 462-6686

Other identifiers 1

IdentifierTypeStateIssuer
141847877OtherNJIRS TAXPAYER I.D. NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120312000036 NJ Practitioner - Chiropractic 8820257801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

124 W Main St
Freehold, NJ 07728-2049
Phone (732) 462-6686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3315NJMDClinical Psychologist
MCO3315NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Atlas Gentle Effective Chiropractic LLC Chiropractor CurrentSince Sep 19, 2002 Accepting new patients

Locations

124 W Main St
Freehold, NJ 07728
Phone (732) 462-6686

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063503092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 W MAIN ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282049",
            "telephone_number": "732-462-6686",
            "fax_number": "732-462-5512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 W MAIN ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282049",
            "telephone_number": "732-462-6686",
            "fax_number": "732-462-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOUGH",
        "first_name": "EILEEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "MCO3315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS TAXPAYER I.D. NUMBER",
            "identifier": "141847877",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.