NPIMap

Organization Active NPI

NJ Spine Group, LLC

  • Orthopaedic Surgery of the Spine Physician
  • Eatontown, NJ
National Provider Identifier
1083773857
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
MA46751 Issued in NJ
Legal business name
NJ SPINE GROUP, LLC
Practice address
234 Industrial Way W
Ste A200
Eatontown, NJ 07724-4244
Phone
(732) 747-7110
Fax
(732) 747-7664
NPI assigned
Dec 7, 2006
Last updated
Sep 10, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

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

Authorized official

Name
Dr. Gordon D Donald, MDNPI 1912936162
Title
Managing Member
Phone
(732) 747-7110

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X MA46751 NJ Primary

Addresses

Primary practice location

234 Industrial Way W
Ste A200
Eatontown, NJ 07724-4244

Mailing address

234 Industrial Way W
Ste A200
Eatontown, NJ 07724-4244
Phone (732) 747-7110

National Provider Directory

National Provider Directory

Locations

234 Industrial Way W
Bldg A
Eatontown, NJ 07724
Phone (732) 747-7110

234 Industrial Way W
Ste A200
Eatontown, NJ 07724
Phone (732) 542-6000

655 Shrewsbury Ave
Fl Second
Shrewsbury, NJ 07702
Phone (732) 747-7110

766 Shrewsbury Ave
#E
Tinton Falls, NJ 07724
Phone (732) 747-7110

766 Shrewsbury Ave
#Eastsuit
Tinton Falls, NJ 07724
Phone (732) 747-7110

Practitioners & affiliated clinicians

Practitioners 7

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": "1165449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441843200000",
    "number": "1083773857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 INDUSTRIAL WAY W",
            "address_2": "STE A200",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077244244",
            "telephone_number": "732-747-7110",
            "fax_number": "732-747-7664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 INDUSTRIAL WAY W",
            "address_2": "STE A200",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077244244",
            "telephone_number": "732-747-7110",
            "fax_number": "732-747-7664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NJ SPINE GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-07",
        "last_updated": "2015-09-10",
        "status": "A",
        "authorized_official_last_name": "DONALD",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "732-747-7110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "NJ",
            "license": "MA46751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eatontown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.