Individual provider Active NPI

Bruce Alan Baver, D.C.

  • Chiropractor
  • Woodbridge, NJ
National Provider Identifier
1366577694
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MC03258 Issued in NJ
Practice address
1 Woodbridge Ctr
Suite 245
Woodbridge, NJ 07095-1150
Phone
(732) 855-8522
Fax
(732) 634-7920
NPI assigned
Feb 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 000583 CT
Chiropractor 111N00000X 004830 NY
Chiropractor 111N00000X 5462 FL
Chiropractor 111N00000X MC03258 NJ Primary

Addresses

Primary practice location

1 Woodbridge Ctr
Suite 245
Woodbridge, NJ 07095-1150

Mailing address

1855 Corporal Kennedy St
Apt. 2K
Bayside, NY 11360-1455
Phone (718) 631-7937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5462FLMDChiropractor
MC03258NJMDChiropractor
004830NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Baver and Corduan Family Chiropractic Health Center P.C. Chiropractor Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366577694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 CORPORAL KENNEDY ST",
            "address_2": "APT. 2K",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113601455",
            "telephone_number": "718-631-7937",
            "fax_number": "732-634-7920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WOODBRIDGE CTR",
            "address_2": "SUITE 245",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070951150",
            "telephone_number": "732-855-8522",
            "fax_number": "732-634-7920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAVER",
        "first_name": "BRUCE",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "000583",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "004830",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "5462",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "MC03258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.