NPIMap

Organization Active NPI

Sports Medicine Center of Bergen, PA

  • Physical Therapist
  • Jersey City, NJ
National Provider Identifier
1194364638
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SPORTS MEDICINE CENTER OF BERGEN, PA
Practice address
201 Marin Blvd
Jersey City, NJ 07302-6491
Phone
(551) 313-7300
Fax
(551) 313-7600
NPI assigned
Jan 2, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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

Authorized official

Name
Kimberly Hunter
Title
Admin Support
Phone
(201) 488-0488

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

201 Marin Blvd
Jersey City, NJ 07302-6491

Mailing address

605 Main St
Hackensack, NJ 07601-5914

Other names 1

  • Excel Orthopedic Rehabilitation Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Excel Orthopedic Rehabi8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577923200000",
    "number": "1194364638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 MAIN ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076015914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 MARIN BLVD",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073026491",
            "telephone_number": "551-313-7300",
            "fax_number": "551-313-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS MEDICINE CENTER OF BERGEN, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-02",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A",
        "authorized_official_last_name": "HUNTER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "ADMIN SUPPORT",
        "authorized_official_telephone_number": "201-488-0488"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excel Orthopedic Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.