Jo Ann Jedryk, D.C.
Individual provider Active NPI Chiropractor · Tabernacle, NJ
NPI 1104959402 · NPPES record last updated Jan 2, 2008
Key facts
- NPI
- 1104959402
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 38MC00302300 (NJ)
- Practice address
- 1531 Route 206
Tabernacle, NJ 08088-8852 - Phone
- (609) 268-3737
- Fax
- (609) 268-3736
- NPI assigned
- Mar 14, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Other, 1984
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1531 Route 206
Tabernacle, NJ 08088-8852
Phone (609) 268-3737
PO Box
Suite 2594
Vincentown, NJ 08088-2594
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081202000207 | NJ | Practitioner - Chiropractic | 9638230287 | Practice locations: Tabernacle, NJ |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38MC00302300 | NJ | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 38MC00302300 | NJ | Yes |
Addresses
Primary practice location
1531 Route 206
Tabernacle, NJ 08088-8852
Mailing address
PO Box 2594
Vincentown, NJ 08088-2594
Phone (609) 268-3737
Other providers in Tabernacle, NJ
- Jane Gersbach
- Lois J. Gerst
- Good Measure Nutrition LLC
- Deborah I Haggett
- Barbara Anne Harbora
- Yoleidy Tatiana Johnstone
- Samantha Kohl
- Aimee Kompel
- Amy Lepsis
- Love Your Smile Dental Center LLC
All providers in Tabernacle, NJ · Chiropractor in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 2, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.