Organization Active NPI

Psota Chiropractic Care and Wellness PC

  • Chiropractor
  • Glen Rock, NJ
National Provider Identifier
1215682018
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PSOTA CHIROPRACTIC CARE AND WELLNESS PC
Practice address
251 Rock Rd Ste 2B
Glen Rock, NJ 07452-1797
Phone
(201) 670-7661
NPI assigned
Feb 21, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Authorized official

Name
Nicole Psota, DCNPI 1215509328
Title
Owner
Phone
(973) 224-9086

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 Primary

Addresses

Primary practice location

251 Rock Rd Ste 2B
Glen Rock, NJ 07452-1797

Mailing address

251 Rock Rd Ste 2B
Glen Rock, NJ 07452-1797
Phone (201) 670-7661

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220729002839 NJ Part B Supplier - Clinic/Group Practice 6901288489 Receives reassigned benefits from 1 practitioner
Practice locations: Glen Rock, NJ

National Provider Directory

National Provider Directory

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": "1645401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645401600000",
    "number": "1215682018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 ROCK RD STE 2B",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074521797",
            "telephone_number": "201-670-7661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 ROCK RD STE 2B",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074521797",
            "telephone_number": "201-670-7661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSOTA CHIROPRACTIC CARE AND WELLNESS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-21",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A",
        "authorized_official_last_name": "PSOTA",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-224-9086",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Rock, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; 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.