Organization Active NPI

Lifestyle Wellness

  • Sports Physician Chiropractor
  • Morristown, NJ
National Provider Identifier
1376117853
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
Legal business name
LIFESTYLE WELLNESS
Practice address
290 Madison Ave Ste 3a
Morristown, NJ 07960-7401
Phone
(973) 590-2448
Fax
(973) 590-2449
NPI assigned
May 18, 2021
Last updated
May 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Authorized official

Name
Dr. Cynthia D'Amelio, DCNPI 1114334133
Title
Doctor of Chiropractic
Phone
(973) 900-0238

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X Primary
Sports Medicine (Internal Medicine) Physician 207RS0010X

Addresses

Primary practice location

290 Madison Ave Ste 3a
Morristown, NJ 07960-7401

Mailing address

224 Norwich CT
Madison, NJ 07940-1134
Phone (973) 900-0238

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210720000491 NJ Part B Supplier - Clinic/Group Practice 0941603617 Receives reassigned benefits from 3 practitioners
Practice locations: Morristown, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621296000000",
    "number": "1376117853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 NORWICH CT",
            "city": "MADISON",
            "state": "NJ",
            "postal_code": "079401134",
            "telephone_number": "973-900-0238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 MADISON AVE STE 3A",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079607401",
            "telephone_number": "973-590-2448",
            "fax_number": "973-590-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLE WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-18",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A",
        "authorized_official_last_name": "D'AMELIO",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "973-900-0238",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.