Michael Wayne Ellin, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00435500 Issued in NJ

Practice address

8004 Lincoln Dr W
Suite F
Marlton, NJ 08053-3213

Phone

(856) 810-1030

Fax

(856) 810-2236

NPI assigned

Jun 23, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1396771143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8004 LINCOLN DR W",
            "address_2": "SUITE F",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533213",
            "telephone_number": "856-810-1030",
            "fax_number": "856-810-2236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8004 LINCOLN DR W",
            "address_2": "SUITE F",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533213",
            "telephone_number": "856-810-1030",
            "fax_number": "856-810-2236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIN",
        "first_name": "MICHAEL",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00435500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.