Organization Active NPI

Journal SQ Spine & Wellness Center LLC

  • Chiropractor
  • Jersey City, NJ
National Provider Identifier
1083256721
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
JOURNAL SQ SPINE & WELLNESS CENTER LLC
Practice address
35 Journal SQ Ste 502
Jersey City, NJ 07306-4007
Phone
(201) 763-7521
Fax
(201) 763-7393
NPI assigned
Oct 15, 2019
Last updated
Oct 15, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2019

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

Authorized official

Name
Bilal Shah, DCNPI 1588037220
Title
Owner/Sole Member
Phone
(201) 763-7521

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

35 Journal SQ Ste 502
Jersey City, NJ 07306-4007

Mailing address

35 Journal SQ Ste 502
Jersey City, NJ 07306-4007
Phone (201) 763-7521

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250312000360 NJ Part B Supplier - Clinic/Group Practice 7113448796 Receives reassigned benefits from 1 practitioner
Practice locations: Jersey City, NJ

National Provider Directory

National Provider Directory

Locations

35 Journal Sq
Ste 502
Jersey City, NJ 07306
Phone (201) 763-7521

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1571097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571097600000",
    "number": "1083256721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 JOURNAL SQ STE 502",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073064007",
            "telephone_number": "201-763-7521",
            "fax_number": "201-763-7393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 JOURNAL SQ STE 502",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073064007",
            "telephone_number": "201-763-7521",
            "fax_number": "201-763-7393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOURNAL SQ SPINE & WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-15",
        "last_updated": "2019-10-15",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "BILAL",
        "authorized_official_title_or_position": "OWNER/SOLE MEMBER",
        "authorized_official_telephone_number": "201-763-7521",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; 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.