Active NPI
Boonton Chiropractic Health Center P.C.
- Sports Physician Chiropractor
- Boonton, NJ
National Provider Identifier
1275704793
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- MCO2777
- Legal business name
- BOONTON CHIROPRACTIC HEALTH CENTER P.C.
- Practice address
- 117 Cornelia St
Boonton, NJ 07005-1709 - Phone
- (973) 335-5400
- Fax
- (973) 335-9194
- NPI assigned
- Mar 13, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Ronald Victor Kern, D.C.
- Title
- President/Chiropractor
- Phone
- (973) 335-5400
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | MCO2777 | NJ | Primary |
Addresses
Primary practice location
117 Cornelia St
Boonton, NJ 07005-1709
Mailing address
117 Cornelia St
Boonton, NJ 07005-1709
Phone (973) 335-5400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Boonton Chiropractic Health Center
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Medical Specialty Clinic/Center
- Boonton, NJ
- NPI 1710049564
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Sports Physician Chiropractor
- Boonton, NJ
- NPI 1306872247
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205366400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1205366400000",
"number": "1275704793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 CORNELIA ST",
"city": "BOONTON",
"state": "NJ",
"postal_code": "070051709",
"telephone_number": "973-335-5400",
"fax_number": "973-335-9194"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 CORNELIA ST",
"city": "BOONTON",
"state": "NJ",
"postal_code": "070051709",
"telephone_number": "973-335-5400",
"fax_number": "973-335-9194"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BOONTON CHIROPRACTIC HEALTH CENTER P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2008-03-13",
"last_updated": "2008-03-13",
"status": "A",
"authorized_official_last_name": "KERN",
"authorized_official_first_name": "RONALD",
"authorized_official_middle_name": "VICTOR",
"authorized_official_title_or_position": "PRESIDENT/CHIROPRACTOR",
"authorized_official_telephone_number": "973-335-5400",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.C."
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor, Sports Physician",
"state": "NJ",
"license": "MCO2777",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boonton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; 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.