NPIMap

Organization Active NPI

Craig Rallo Chiropractor,LLC

  • Chiropractor
  • Old Bridge, NJ
National Provider Identifier
1114455201
Registry record updated Jun 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC0062550 Issued in NJ
Legal business name
CRAIG RALLO CHIROPRACTOR,LLC
Practice address
2698 County Rd 516 Ste C
Old Bridge, NJ 08857-2305
Phone
(732) 679-1100
Fax
(732) 679-5770
NPI assigned
Jun 1, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2017

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

Authorized official

Name
Dr. Craig Rallo, DCNPI 1700959368
Title
Owner
Phone
(732) 679-1100

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 38MC0062550 NJ Primary

Addresses

Primary practice location

2698 County Rd 516 Ste C
Old Bridge, NJ 08857-2305

Mailing address

2698 County Rd 516 Ste C
Old Bridge, NJ 08857-2305
Phone (732) 679-1100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170622000595 NJ Part B Supplier - Clinic/Group Practice 2466720073 Receives reassigned benefits from 6 practitioners
Practice locations: Lanoka Harbor, NJ; Old Bridge, NJ

National Provider Directory

National Provider Directory

Locations

2698 Highway 516
Ste C
Old Bridge, NJ 08857
Phone (732) 679-1100

Practitioners & affiliated clinicians

Practitioners 7

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": "1496275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498176000000",
    "number": "1114455201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2698 COUNTY RD 516 STE C",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572305",
            "telephone_number": "732-679-1100",
            "fax_number": "732-679-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2698 COUNTY RD 516 STE C",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572305",
            "telephone_number": "732-679-1100",
            "fax_number": "732-679-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAIG RALLO CHIROPRACTOR,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-01",
        "last_updated": "2017-06-23",
        "status": "A",
        "authorized_official_last_name": "RALLO",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-679-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC0062550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Bridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2017; 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.