Active NPI
Back2Health Chiropractic Center, LLC
- Chiropractor
- Hackensack, NJ
National Provider Identifier
1114197597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 38MC00663600
- Legal business name
- BACK2HEALTH CHIROPRACTIC CENTER, LLC
- Practice address
- 180 Grand Ave
Hackensack, NJ 07601-4705 - Phone
- (201) 820-3343
- Fax
- (201) 820-3344
- NPI assigned
- Mar 3, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Edward Shmaruk, DC
- Title
- Chiropractor
- Phone
- (201) 819-9748
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 38MC00663600 | NJ | Primary |
Addresses
Primary practice location
180 Grand Ave
Hackensack, NJ 07601-4705
Mailing address
180 Grand Ave
Hackensack, NJ 07601-4705
Phone (201) 820-3343
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080604000134 | NJ | Part B Supplier - Clinic/Group Practice | 0143390013 |
Receives reassigned benefits from 5 practitioners Practice locations: Fair Lawn, NJ |
National Provider Directory
National Provider DirectoryLocations
33-00 Broadway
Ste 209
Fair Lawn, NJ 07410
Phone (201) 796-7666
180 Grand Ave
Hackensack, NJ 07601
Phone (201) 820-3343
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Chiropractor
- Fair Lawn, NJ
- NPI 1093991606
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204502400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1249862400000",
"number": "1114197597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "180 GRAND AVE",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "076014705",
"telephone_number": "201-820-3343",
"fax_number": "201-820-3344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 GRAND AVE",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "076014705",
"telephone_number": "201-820-3343",
"fax_number": "201-820-3344"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BACK2HEALTH CHIROPRACTIC CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-03-03",
"last_updated": "2009-08-10",
"status": "A",
"authorized_official_last_name": "SHMARUK",
"authorized_official_first_name": "EDWARD",
"authorized_official_title_or_position": "CHIROPRACTOR",
"authorized_official_telephone_number": "201-819-9748",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "DC"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "NJ",
"license": "38MC00663600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hackensack, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2009; 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.