Organization Active NPI

Perth Amboy Chiropractic Health Center, P.a.

  • Chiropractor
  • Perth Amboy, NJ
National Provider Identifier
1235400672
Registry record updated Jan 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00335600 Issued in NJ
Legal business name
PERTH AMBOY CHIROPRACTIC HEALTH CENTER, P.A.
Practice address
613 Amboy Ave
Perth Amboy, NJ 08861-2645
Phone
(732) 442-5552
Fax
(732) 324-0069
NPI assigned
Jan 17, 2012
Last updated
Jan 17, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2012

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

Authorized official

Name
Dr. James C Wolff, D.C.NPI 1891761375
Title
Director
Phone
(732) 442-5552

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 38MC00335600 NJ Primary

Addresses

Primary practice location

613 Amboy Ave
Perth Amboy, NJ 08861-2645

Mailing address

613 Amboy Ave
Perth Amboy, NJ 08861-2645
Phone (732) 442-5552

Other identifiers 1

IdentifierTypeStateIssuer
3331300MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120126000340 NJ Part B Supplier - Clinic/Group Practice 9638346034 Receives reassigned benefits from 1 practitioner
Practice locations: Perth Amboy, NJ

National Provider Directory

National Provider Directory

Locations

613 Amboy Ave
Perth Amboy, NJ 08861
Phone (732) 442-5552

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1326758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326758400000",
    "number": "1235400672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 AMBOY AVE",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088612645",
            "telephone_number": "732-442-5552",
            "fax_number": "732-324-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 AMBOY AVE",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088612645",
            "telephone_number": "732-442-5552",
            "fax_number": "732-324-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERTH AMBOY CHIROPRACTIC HEALTH CENTER, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-17",
        "last_updated": "2012-01-17",
        "status": "A",
        "authorized_official_last_name": "WOLFF",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "732-442-5552",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00335600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3331300",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Perth Amboy, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2012; 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.