NPIMap

Organization Active NPI

The Source Wellness Center LLC

  • Chiropractor
  • Rahway, NJ
National Provider Identifier
1396217527
Registry record updated Dec 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
THE SOURCE WELLNESS CENTER LLC
Practice address
1275 Westfield Ave Ste 1
Rahway, NJ 07065-1900
Phone
(732) 978-0951
NPI assigned
Dec 28, 2018
Last updated
Dec 28, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2018

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

Authorized official

Name
Dr. Kyle Bilquist, D.C.NPI 1164870143
Title
Owner
Phone
(732) 978-0951

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1275 Westfield Ave Ste 1
Rahway, NJ 07065-1900

Mailing address

1275 Westfield Ave Ste 1
Rahway, NJ 07065-1900
Phone (732) 978-0951

National Provider Directory

National Provider Directory

Locations

1275 Westfield Ave
Ste 1
Rahway, NJ 07065
Phone (732) 978-0951

Practitioners & affiliated clinicians

Practitioners 1

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": "1545955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545955200000",
    "number": "1396217527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 WESTFIELD AVE STE 1",
            "city": "RAHWAY",
            "state": "NJ",
            "postal_code": "070651900",
            "telephone_number": "732-978-0951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 WESTFIELD AVE STE 1",
            "city": "RAHWAY",
            "state": "NJ",
            "postal_code": "070651900",
            "telephone_number": "732-978-0951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SOURCE WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-28",
        "last_updated": "2018-12-28",
        "status": "A",
        "authorized_official_last_name": "BILQUIST",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-978-0951",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rahway, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2018; 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.