South Jersey Spinal Care Center, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00336300 Issued in NJ

Legal business name

SOUTH JERSEY SPINAL CARE CENTER, LLC

Practice address

1201 New Rd
Suite 117-B
Linwood, NJ 08221-1150

Phone

(609) 653-0700

Fax

(609) 653-0017

NPI assigned

Apr 7, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Christopher Joseph Depolis Jr., D.C.

Title

President

Phone

(609) 653-0700

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207526400000",
    "number": "1235302639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 NEW RD",
            "address_2": "SUITE 117-B",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "082211150",
            "telephone_number": "609-653-0700",
            "fax_number": "609-653-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 NEW RD",
            "address_2": "SUITE 117-B",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "082211150",
            "telephone_number": "609-653-0700",
            "fax_number": "609-653-0017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH JERSEY SPINAL CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-07",
        "last_updated": "2008-04-07",
        "status": "A",
        "authorized_official_last_name": "DEPOLIS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "609-653-0700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00336300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2008; 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.