Advanced Spine & Sports Performance

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

Legal business name

ADVANCED SPINE & SPORTS PERFORMANCE

Practice address

149 Horseneck Rd
Fairfield, NJ 07004-2306

Phone

(973) 851-9188

Fax

(201) 228-9980

NPI assigned

Jun 28, 2016

Last updated

Jun 28, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Charles Bronder, D.C.NPI 1760689632

Title

President

Phone

(973) 851-9188

Specialties & licenses 2

Addresses

Practitioners 1

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.

• Charles Joseph Bronder Jr., D.C.

  • Sports Physician Chiropractor
  • Englewood Cliffs, NJ
  • NPI 1760689632
  NPD (past) Authorized official

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467072000000",
    "number": "1336590652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 HORSENECK RD",
            "city": "FAIRFIELD",
            "state": "NJ",
            "postal_code": "070042306",
            "telephone_number": "973-851-9188",
            "fax_number": "201-228-9980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 HORSENECK RD",
            "city": "FAIRFIELD",
            "state": "NJ",
            "postal_code": "070042306",
            "telephone_number": "973-851-9188",
            "fax_number": "201-228-9980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SPINE & SPORTS PERFORMANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-28",
        "last_updated": "2016-06-28",
        "status": "A",
        "authorized_official_last_name": "BRONDER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-851-9188",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "NJ",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sports Physician Chiropractor in Fairfield, NJ
• Providers in Fairfield, NJ by specialty
• Sports Physician Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2016; 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.