Active NPI
Derek Andrew Van Benthuysen, D.C.
- Chiropractor
- Wall Township, NJ
National Provider Identifier
1376604728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- MC05589
- Practice address
- 3350 Highway 138
Ste 227
Wall Township, NJ 07719-9694 - Phone
- (732) 280-1800
- NPI assigned
- Dec 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | MC05589 | NJ | Primary |
Addresses
Primary practice location
3350 Highway 138
Ste 227
Wall Township, NJ 07719-9694
Mailing address
3350 Highway 138
Ste 227
Wall Township, NJ 07719-9694
Phone (732) 280-1800
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583107200000",
"number": "1376604728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3350 HIGHWAY 138",
"address_2": "STE 227",
"city": "WALL TOWNSHIP",
"state": "NJ",
"postal_code": "077199694",
"telephone_number": "732-280-1800",
"fax_number": "732-280-2323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3350 HIGHWAY 138",
"address_2": "STE 227",
"city": "WALL TOWNSHIP",
"state": "NJ",
"postal_code": "077199694",
"telephone_number": "732-280-1800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN BENTHUYSEN",
"first_name": "DEREK",
"middle_name": "ANDREW",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-12",
"last_updated": "2020-03-02",
"certification_date": "2020-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NJ",
"license": "MC05589",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wall Township, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.