Organization Active NPI

Kevin R. Candino DC LLC

  • Chiropractor
  • Manalapan, NJ
National Provider Identifier
1447425087
Registry record updated May 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00609600 Issued in NJ
Legal business name
KEVIN R. CANDINO DC LLC
Practice address
4 Bridge Plaza Dr
Manalapan, NJ 07726-1746
Phone
(732) 970-6191
NPI assigned
Apr 24, 2008
Last updated
May 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2008

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

Authorized official

Name
Dr. Kevin R. Candino, CHIROPRACTORNPI 1427100833
Title
President
Phone
(732) 970-6191

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
Chiropractor 111N00000X 38MC00609600 NJ Primary

Addresses

Primary practice location

4 Bridge Plaza Dr
Manalapan, NJ 07726-1746

Mailing address

4 Bridge Plaza Dr
Manalapan, NJ 07726-1746
Phone (732) 970-6191

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080502000501 NJ Part B Supplier - Clinic/Group Practice 4385723253 Receives reassigned benefits from 1 practitioner
Practice locations: Manalapan, NJ

National Provider Directory

National Provider Directory

Locations

4 Bridge Plaza Dr
Manalapan, NJ 07726
Phone (732) 970-6191

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": "1208995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1447425087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 BRIDGE PLAZA DR",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077261746",
            "telephone_number": "732-970-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 BRIDGE PLAZA DR",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077261746",
            "telephone_number": "732-970-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN R. CANDINO DC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-24",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "CANDINO",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-970-6191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "CHIROPRACTOR"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00609600",
            "primary": true
        }
    ],
    "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 May 5, 2008; 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.