Atlantic Wellness and Spine Center, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00666700 Issued in NJ

Legal business name

ATLANTIC WELLNESS AND SPINE CENTER, LLC

Practice address

1171 Fischer Blvd
Suite 5
Toms River, NJ 08753-3090

Phone

(732) 270-2811

Fax

(732) 270-2911

NPI assigned

Apr 15, 2014

Organization subpart

No

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

Authorized official

Name

Siobhan Pakenham, D.C.NPI 1144371691

Title

Owner/Chiropractor

Phone

(732) 320-2041

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Siobhan Ann Pakenham, D.C.

  • Chiropractor
  • Toms River, NJ
  • NPI 1144371691
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409097600000",
    "number": "1386063600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1171 FISCHER BLVD",
            "address_2": "SUITE 5",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087533090",
            "telephone_number": "732-270-2811",
            "fax_number": "732-270-2911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 FISCHER BLVD",
            "address_2": "SUITE 5",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087533090",
            "telephone_number": "732-270-2811",
            "fax_number": "732-270-2911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC WELLNESS AND SPINE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-15",
        "last_updated": "2014-08-27",
        "status": "A",
        "authorized_official_last_name": "PAKENHAM",
        "authorized_official_first_name": "SIOBHAN",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "732-320-2041",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00666700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Atlantic Family Medicine LLC
• Atlantic Physical Medicine & Rehabilitation Center P a
• Atlantic Physical Therapy Center
• Atlantic Pulmonary and Sleep Disorders Association PA
• Atlantic Transit Care
• Atlantic Wellness Group
• Attaining Big Progress
• Michelle Au, DDS
• Audiology Distribution, LLC (HearUSA)
• Audiology Services Company USA, LLC

• Chiropractor in Toms River, NJ
• Providers in Toms River, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; 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.