Organization Active NPI

Avon Chiropractic Center LLC

  • Chiropractor
  • Avon by the Sea, NJ
National Provider Identifier
1194043604
Registry record updated May 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00341500 Issued in NJ
Legal business name
AVON CHIROPRACTIC CENTER LLC
Practice address
516 Lincoln Ave
Avon by the Sea, NJ 07717-1155
Phone
(732) 988-8596
NPI assigned
May 7, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2010

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

Authorized official

Name
Frederick G Mayer, D.C.NPI 1811082894
Title
Sole Member/Proprietor
Phone
(732) 988-8596

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 38MC00341500 NJ Primary

Addresses

Primary practice location

516 Lincoln Ave
Avon by the Sea, NJ 07717-1155

Mailing address

516 Lincoln Ave
Avon by the Sea, NJ 07717-1155
Phone (732) 988-8596

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100604000689 NJ Part B Supplier - Clinic/Group Practice 9133259955 Receives reassigned benefits from 1 practitioner
Practice locations: Avon by the Sea, NJ

National Provider Directory

National Provider Directory

Locations

516 Lincoln Ave
Avon by the Sea, NJ 07717
Phone (732) 988-8596

Practitioners & affiliated clinicians

Practitioners 1

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": "1273190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273190400000",
    "number": "1194043604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 LINCOLN AVE",
            "city": "AVON BY THE SEA",
            "state": "NJ",
            "postal_code": "077171155",
            "telephone_number": "732-988-8596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 LINCOLN AVE",
            "city": "AVON BY THE SEA",
            "state": "NJ",
            "postal_code": "077171155",
            "telephone_number": "732-988-8596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVON CHIROPRACTIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-07",
        "last_updated": "2010-05-07",
        "status": "A",
        "authorized_official_last_name": "MAYER",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "SOLE MEMBER/PROPRIETOR",
        "authorized_official_telephone_number": "732-988-8596",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00341500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon by the Sea, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2010; 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.