Back to Life Wellness & Rehabilitation

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

QA01105600 Issued in NJ

Legal business name

BACK TO LIFE WELLNESS & REHABILITATION

Practice address

1930 Marlton Pike E
Suite E27
Cherry Hill, NJ 08003-2150

Phone

(856) 424-6677

Fax

(856) 489-1803

NPI assigned

Dec 4, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Meghan Rendfrey McDonough, DPTNPI 1568520625

Title

Administrative Director

Phone

(856) 424-6677

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Back To Life Physical Therapy Other name

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Meghan Rendfrey McDonough, DPT

  • Physical Therapist
  • Cherry Hill, NJ
  • NPI 1568520625
  Medicare reassignment Care Compare group NPD Authorized official
• Brendan Michael McDonough, DPT

  • Physical Therapist
  • Cherry Hill, NJ
  • NPI 1578621629
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215095385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 MARLTON PIKE E",
            "address_2": "SUITE E27",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080032150",
            "telephone_number": "856-424-6677",
            "fax_number": "856-489-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 MARLTON PIKE E",
            "address_2": "SUITE E27",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080032150",
            "telephone_number": "856-424-6677",
            "fax_number": "856-489-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK TO LIFE WELLNESS & REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCDONOUGH",
        "authorized_official_first_name": "MEGHAN",
        "authorized_official_middle_name": "RENDFREY",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "856-424-6677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NJ",
            "license": "QA01105600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IND BCBS PERSONAL CHOICE",
            "identifier": "2356263000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH ID",
            "identifier": "2356263000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Back To Life Physical Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Charlene Smith Babin, LPN
• Melissa Bacchus, PA-C
• Paolo Viloria Bacero, PT
• Charles Joseph Bachi IV, PT, DPT, OCS, SCS
• Benedict J Bachstein, DMD
• Lyle Marnin Back, M.D.
• Brittany Backman
• Katherine Nicole Bacola
• Shane Baduini
• Ashley C Baggett, PT

• Physical Therapy Clinic/Center in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• Physical Therapy Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.