Nexgen Wellness

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

NEXGEN WELLNESS

Practice address

231 Main St Unit 266
Fort Lee, NJ 07024-5740

Phone

(973) 557-1506

Fax

(973) 954-2115

NPI assigned

May 26, 2020

Organization subpart

No

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

Authorized official

Name

Danielle Odom

Title

Administrator

Phone

(973) 557-1506

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1590451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697068800000",
    "number": "1285257212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 MAIN ST UNIT 266",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070245740",
            "telephone_number": "973-557-1506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 MAIN ST UNIT 266",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070245740",
            "telephone_number": "973-557-1506",
            "fax_number": "973-954-2115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEXGEN WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-26",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A",
        "authorized_official_last_name": "ODOM",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "973-557-1506"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "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 Oct 12, 2023; 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.