Integrative Functional Medicine Associates LLC

Primary specialty

Spinal Cord Injury Medicine PhysicianTaxonomy code 2081P0004X

License

25MA07295900 Issued in NJ

Legal business name

INTEGRATIVE FUNCTIONAL MEDICINE ASSOCIATES LLC

Practice address

292 Bloomfield Ave
2ND Floor
Montclair, NJ 07042-3624

Phone

(973) 928-8909

Fax

(201) 967-8425

NPI assigned

May 3, 2010

Organization subpart

No

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

Authorized official

Name

Jodi ThomasNPI 1912003765

Title

MD

Phone

(201) 967-8425

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Jodi Thomas, MD

  • Physical Medicine & Rehabilitation Physician
  • Wharton, NJ
  • NPI 1912003765
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1272844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272844800000",
    "number": "1063739829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 WATCHUNG PLZ",
            "address_2": "SUITE 345",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424117",
            "telephone_number": "201-967-8425",
            "fax_number": "201-967-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 BLOOMFIELD AVE",
            "address_2": "2ND FLOOR",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423624",
            "telephone_number": "973-928-8909",
            "fax_number": "201-967-8425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE FUNCTIONAL MEDICINE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-03",
        "last_updated": "2010-05-03",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "JODI",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "201-967-8425"
    },
    "taxonomies": [
        {
            "code": "2081P0004X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine",
            "state": "NJ",
            "license": "25MA07295900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005466",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Integrated Medical Associates LLC (na)
• Integrative Spine & Orthopedic Rehabilitation
• Nanci Jean Iovino
• Israel Martinez, LCSW LLC
• Joseph Robert Ivan, M.D.
• Rachel Ivanhoe, MD

• Spinal Cord Injury Medicine Physician in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Spinal Cord Injury Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2010; 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.