Organization Active NPI

Demoulin Chiropractic Center

  • Sports Physician Chiropractor
  • Marmora, NJ
National Provider Identifier
1114014271
Registry record updated Oct 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
38MC00282200 Issued in NJ
Legal business name
DEMOULIN CHIROPRACTIC CENTER
Practice address
52 Tuckahoe Rd
Marmora, NJ 08223-1206
Phone
(609) 390-8490
Fax
(609) 845-1850
NPI assigned
Oct 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2014

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

Authorized official

Name
Dr. Louis L Demoulin, D.C.NPI 1184713398
Title
Owner
Phone
(609) 390-8490

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
Sports Physician ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NS0005X 38MC00282200 NJ Primary

Addresses

Primary practice location

52 Tuckahoe Rd
Marmora, NJ 08223-1206

Mailing address

52 Tuckahoe Rd
Marmora, NJ 08223-1206
Phone (609) 390-8490

Other identifiers 1

IdentifierTypeStateIssuer
070080OtherMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110608000770 NJ Part B Supplier - Clinic/Group Practice 2062699598 Receives reassigned benefits from 2 practitioners
Practice locations: Marmora, NJ; Mays Landing, NJ

National Provider Directory

National Provider Directory

Locations

52 Tuckahoe Rd
Marmora, NJ 08223
Phone (609) 309-8490

6041 Main St
Mays Landing, NJ 08330
Phone (609) 625-0160

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412553600000",
    "number": "1114014271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 TUCKAHOE RD",
            "city": "MARMORA",
            "state": "NJ",
            "postal_code": "082231206",
            "telephone_number": "609-390-8490",
            "fax_number": "609-845-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 TUCKAHOE RD",
            "city": "MARMORA",
            "state": "NJ",
            "postal_code": "082231206",
            "telephone_number": "609-390-8490",
            "fax_number": "609-845-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEMOULIN CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2014-10-06",
        "status": "A",
        "authorized_official_last_name": "DEMOULIN",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-390-8490",
        "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": "38MC00282200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "070080",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marmora, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2014; 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.