Dr. Bill Ross, DC, LLC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

38MC00569700 Issued in NJ

Legal business name

DR. BILL ROSS, DC, LLC

Practice address

160 S New York Rd
C4
Galloway, NJ 08205-3820

Phone

(609) 748-1099

Fax

(609) 748-1216

NPI assigned

Dec 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. William M Ross, D.C.NPI 1710926175

Title

Owner

Phone

(609) 748-1099

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

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

• William M Ross, D.C.

  • Sports Physician Chiropractor
  • Galloway, NJ
  • NPI 1710926175
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644969600000",
    "number": "1073673588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 E JIMMIE LEEDS RD STE C4",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082054125",
            "telephone_number": "097-481-0996",
            "fax_number": "609-748-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 S NEW YORK RD",
            "address_2": "C4",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082053820",
            "telephone_number": "609-748-1099",
            "fax_number": "609-748-1216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. BILL ROSS, DC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-748-1099",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "NJ",
            "license": "38MC00569700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9130802",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Johanna Rose Durazzi, LSW
• Donna Pharo Dykes, PTA
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• Mona Elgenaidi, M.D.

• Sports Physician Chiropractor in Galloway, NJ
• Providers in Galloway, NJ by specialty
• Sports Physician Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; 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.