Active NPI
Ronald V Kern, D. C.
- Sports Physician Chiropractor
- Boonton, NJ
National Provider Identifier
1306872247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- MCO2777
- Practice address
- 117 Cornelia St
Boonton, NJ 07005-1709 - Phone
- (973) 335-5400
- Fax
- (973) 335-9194
- NPI assigned
- Jun 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
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
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00787233 | Other | NJ | MEDICARE PTAN |
| 3370003 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- New York Chiropractic College, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
117 Cornelia St
Boonton, NJ 07005-1709
Phone (973) 335-5400
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MCO2777 | NJ | MD | Sports Physician Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boonton Chiropractic Health Center,P.C. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Sports Physician Chiropractor
- Boonton, NJ
- NPI 1275704793
-
- Medical Specialty Clinic/Center
- Boonton, NJ
- NPI 1710049564
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266796800000",
"number": "1306872247",
"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": {
"last_name": "KERN",
"first_name": "RONALD",
"middle_name": "V",
"name_prefix": "Dr.",
"credential": "D. C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-23",
"last_updated": "2010-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "NJ",
"license": "MCO2777",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "P00787233",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3370003",
"state": "NJ"
}
],
"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 Feb 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.