Individual provider Active NPI

Kara Conroy, DC

  • Chiropractor
  • Fanwood, NJ
National Provider Identifier
1366194540
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00788900 Issued in NJ
Practice address
313 South Ave Ste 205
Fanwood, NJ 07023-1364
Phone
(704) 201-3789
NPI assigned
Jan 19, 2022
Last updated
Jan 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00788900 NJ Primary

Addresses

Primary practice location

313 South Ave Ste 205
Fanwood, NJ 07023-1364

Mailing address

245 Kramer Ave
Staten Island, NY 10309-4226

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220203000637 NJ Practitioner - Chiropractic 8921491549 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Functional Performance Institute PCGroup PAC ID 0749425312, 2 clinicians

Practice addresses (Care Compare)

313 S Ave
Suite 203
Fanwood, NJ 07023-1364
Phone (908) 288-7049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00788900NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Functional Performance Institute PC Chiropractor CurrentSince Jan 18, 2022 Accepting new patients

Locations

781 Brick Blvd
Brick, NJ 08723
Phone (732) 428-7472

313 South Ave
Ste 203
Fanwood, NJ 07023
Phone (908) 288-7049

313 South Ave
Ste 205
Fanwood, NJ 07023
Phone (908) 288-7049

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1366194540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 KRAMER AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103094226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 SOUTH AVE STE 205",
            "city": "FANWOOD",
            "state": "NJ",
            "postal_code": "070231364",
            "telephone_number": "704-201-3789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONROY",
        "first_name": "KARA",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00788900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fanwood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; 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.