Organization Active NPI

Southern Ocean Chiropractic

  • Chiropractor
  • Manahawkin, NJ
National Provider Identifier
1295869378
Registry record updated Apr 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00410700 Issued in NJ
Legal business name
SOUTHERN OCEAN CHIROPRACTIC
Practice address
703 Mill Creek Rd Ste C
Manahawkin, NJ 08050-3828
Phone
(609) 597-3111
Fax
(609) 597-5112
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2017

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

Authorized official

Name
Dr. Brian C Smith, D.C.NPI 1487672689
Title
Owner
Phone
(609) 597-3111

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 38MC00410700 NJ Primary

Addresses

Primary practice location

703 Mill Creek Rd Ste C
Manahawkin, NJ 08050-3828

Mailing address

703 Mill Creek Rd Ste C
Manahawkin, NJ 08050-3828
Phone (609) 597-3111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140109000203 NJ Part B Supplier - Clinic/Group Practice 8123256682 Receives reassigned benefits from 1 practitioner
Practice locations: Manahawkin, NJ

National Provider Directory

National Provider Directory

Locations

703 Mill Creek Rd
Ste C
Manahawkin, NJ 08050
Phone (609) 597-3111

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493078400000",
    "number": "1295869378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 MILL CREEK RD STE C",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080503828",
            "telephone_number": "609-597-3111",
            "fax_number": "609-597-5112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 MILL CREEK RD STE C",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080503828",
            "telephone_number": "609-597-3111",
            "fax_number": "609-597-5112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN OCEAN CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2017-04-25",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-597-3111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00410700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manahawkin, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; 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.