Individual provider Active NPI

Jeanette L Cullen, DC

  • Chiropractor
  • Elizabeth, NJ
National Provider Identifier
1427201888
Registry record updated Nov 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00438500 Issued in NJ
Practice address
700 N Broad St
Suite LL2
Elizabeth, NJ 07208-2310
Phone
(908) 349-0677
Fax
(908) 352-6865
NPI assigned
Oct 29, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00438500 NJ Primary

Addresses

Primary practice location

700 N Broad St
Suite LL2
Elizabeth, NJ 07208-2310

Mailing address

700 N Broad St
Suite LL2
Elizabeth, NJ 07208-2310
Phone (908) 349-0677

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
38MC00438500NJMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1225238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383782400000",
    "number": "1427201888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N BROAD ST",
            "address_2": "SUITE LL2",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072082310",
            "telephone_number": "908-349-0677",
            "fax_number": "908-352-6865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N BROAD ST",
            "address_2": "SUITE LL2",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072082310",
            "telephone_number": "908-349-0677",
            "fax_number": "908-352-6865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLEN",
        "first_name": "JEANETTE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-29",
        "last_updated": "2013-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00438500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2013; 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.