Individual provider Active NPI

Taraanne Keating Lawicki, DC

  • Chiropractor
  • Red Bank, NJ
National Provider Identifier
1346451101
Registry record updated Jan 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104556531 Issued in VA
Practice address
590 Highway 35
Suite 1
Red Bank, NJ 07701-5048
Phone
(732) 796-0333
Fax
(732) 796-0335
NPI assigned
May 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104556531 VA Primary
Chiropractor 111N00000X 38MC00680800 NJ

Addresses

Primary practice location

590 Highway 35
Suite 1
Red Bank, NJ 07701-5048

Mailing address

590 Highway 35
Suite 1
Red Bank, NJ 07701-5048
Phone (732) 796-0333

Other identifiers 2

IdentifierTypeStateIssuer
0104556531OtherVASTATE MEDICAL LICENSE #
38MC00680800OtherNJSTATE MEDICAL LICENSE #

Other names 1

  • Tara Anne Keating Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120518000026 NJ Practitioner - Chiropractic 5991986473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

590 Hwy 35
Suite 1
Red Bank, NJ 07701-5067
Phone (732) 930-6532

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00680800NJMDChiropractor
0104556531VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Be Your Best Chiropractic, LLC Chiropractor CurrentSince May 1, 2016 Accepting new patients
New Jersey Spine & Disc Center,LLC Chiropractor Past Accepting new patients

Locations

590 Highway 35
Ste 1
Red Bank, NJ 07701
Phone (732) 796-0333

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.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420761600000",
    "number": "1346451101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 HIGHWAY 35",
            "address_2": "SUITE 1",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015048",
            "telephone_number": "732-796-0333",
            "fax_number": "732-796-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 HIGHWAY 35",
            "address_2": "SUITE 1",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015048",
            "telephone_number": "732-796-0333",
            "fax_number": "732-796-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWICKI",
        "first_name": "TARAANNE",
        "middle_name": "KEATING",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2015-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556531",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00680800",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE #",
            "identifier": "0104556531",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE #",
            "identifier": "38MC00680800",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "KEATING",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Red Bank, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; 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.

Verify at the official NPI Registry.