Active NPI
Gonthar S. Rooda, D.C.
- Chiropractor
- Princeton, NJ
National Provider Identifier
1174532873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2100
- Practice address
- 759 State Rd
Princeton, NJ 08540-1421 - Phone
- (609) 921-6056
- Fax
- (609) 921-6056
- NPI assigned
- Aug 5, 2006
- 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 | 2100 | NJ | Primary |
Addresses
Primary practice location
759 State Rd
Princeton, NJ 08540-1421
Mailing address
759 State Rd
Princeton, NJ 08540-1421
Phone (609) 921-6056
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 562483 | Other | NJ | AETNA # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2100 | NJ | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174532873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "759 STATE RD",
"city": "PRINCETON",
"state": "NJ",
"postal_code": "085401421",
"telephone_number": "609-921-6056",
"fax_number": "609-921-6056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "759 STATE RD",
"city": "PRINCETON",
"state": "NJ",
"postal_code": "085401421",
"telephone_number": "609-921-6056",
"fax_number": "609-921-6056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROODA",
"first_name": "GONTHAR",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NJ",
"license": "2100",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA #",
"identifier": "562483",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Princeton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.