NPIMap

Organization Active NPI

Destination Wellness Center Inc.

  • Chiropractor
  • Manalapan, NJ
National Provider Identifier
1437606472
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00624900 Issued in NJ
Legal business name
DESTINATION WELLNESS CENTER INC.
Practice address
227 Taylors Mills Rd
Manalapan, NJ 07726-3229
Phone
(732) 780-7333
Fax
(732) 358-0921
NPI assigned
Sep 7, 2016
Last updated
Sep 7, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

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

Authorized official

Name
Dr. Richard L Allen, D.C.NPI 1205983715
Title
Owner/Ceo
Phone
(732) 780-7333

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 38MC00624900 NJ Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X X010584-1 NY

Addresses

Primary practice location

227 Taylors Mills Rd
Manalapan, NJ 07726-3229

Mailing address

227 Taylors Mills Rd
Manalapan, NJ 07726-3229
Phone (732) 780-7333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170213000903 NJ Part B Supplier - Clinic/Group Practice 6103109426 Receives reassigned benefits from 1 practitioner
Practice locations: Manalapan, NJ

National Provider Directory

National Provider Directory

Locations

227 Taylors Mills Rd
Manalapan, NJ 07726
Phone (732) 780-7333

Practitioners & affiliated clinicians

Practitioners 2

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": "1473206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473206400000",
    "number": "1437606472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 TAYLORS MILLS RD",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077263229",
            "telephone_number": "732-780-7333",
            "fax_number": "732-358-0921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 TAYLORS MILLS RD",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077263229",
            "telephone_number": "732-780-7333",
            "fax_number": "732-358-0921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTINATION WELLNESS CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-07",
        "last_updated": "2016-09-07",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "732-780-7333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00624900",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X010584-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manalapan, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; 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.