Active NPI
Christian Wagner
- Chiropractor
- Clifton, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 38MC00801700
- Practice address
- 1233 Main Ave
Clifton, NJ 07011-2241 - Phone
- (973) 604-0260
- NPI assigned
- Jan 12, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 38MC00801700 | NJ | Primary |
Addresses
Primary practice location
1233 Main Ave
Clifton, NJ 07011-2241
Mailing address
21 Stone CT
Morristown, NJ 07960-3177
Phone (518) 937-6894
Other practice location 1
5665 John F. Kennedy Blvd
North Bergen, NJ 07047
Phone (973) 834-8586
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5665 JFK Boulevard
Suite 7
North Bergen, NJ 07047-3223
Phone (973) 692-6400
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sportsmed PT LLC | Chiropractor | Current | Accepting new patients |
Locations
1233 Main Ave
Clifton, NJ 07011
Phone (973) 595-6444
266 Harristown Rd
Ste 304
Glen Rock, NJ 07452
Phone (201) 345-5798
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705017600000",
"number": "1114798642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 STONE CT",
"city": "MORRISTOWN",
"state": "NJ",
"postal_code": "079603177",
"telephone_number": "518-937-6894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1233 MAIN AVE",
"city": "CLIFTON",
"state": "NJ",
"postal_code": "070112241",
"telephone_number": "973-604-0260"
}
],
"practiceLocations": [
{
"address_1": "5665 John F. Kennedy Blvd",
"address_purpose": "LOCATION",
"city": "North Bergen",
"state": "NJ",
"postal_code": "07047",
"country_code": "US",
"telephone_number": "973-834-8586",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WAGNER",
"first_name": "CHRISTIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-01-12",
"last_updated": "2024-01-12",
"certification_date": "2024-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NJ",
"license": "38MC00801700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clifton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.