Organization Active NPI

CG Health & Wellness LLC

  • Family Medicine Physician
  • Cedar Grove, NJ
National Provider Identifier
1285356766
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CG HEALTH & WELLNESS LLC
Practice address
870 Pompton Ave
Cedar Grove, NJ 07009-1203
Phone
(973) 433-0889
NPI assigned
Sep 13, 2022
Last updated
Sep 16, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Authorized official

Name
Dr. Roth Riley, MDNPI 1831241264
Title
Admin
Phone
(973) 742-6260

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

870 Pompton Ave
Cedar Grove, NJ 07009-1203

Mailing address

870 Pompton Ave
Cedar Grove, NJ 07009-1203
Phone (973) 433-0889

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL file Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230223001272 NJ Part B Supplier - Clinic/Group Practice 1557734456 Receives reassigned benefits from 2 practitioners
Practice locations: Cedar Grove, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1663027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663286400000",
    "number": "1285356766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 POMPTON AVE",
            "city": "CEDAR GROVE",
            "state": "NJ",
            "postal_code": "070091203",
            "telephone_number": "973-433-0889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 POMPTON AVE",
            "city": "CEDAR GROVE",
            "state": "NJ",
            "postal_code": "070091203",
            "telephone_number": "973-433-0889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CG HEALTH & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-13",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "ROTH",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "973-742-6260",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "file",
            "affiliation": "N",
            "endpointDescription": "document",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "870 Pompton Ave",
            "city": "Cedar Grove",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070091203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cedar Grove, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.