Individual provider Active NPI

Michael Gerard Degeorge, D.C.

  • Chiropractor
  • Rahway, NJ
National Provider Identifier
1447457114
Registry record updated Jan 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MC04134 Issued in NJ
Practice address
1600 Saint Georges Ave
Ste 118
Rahway, NJ 07065-2764
Phone
(732) 428-5566
Fax
(732) 428-5513
NPI assigned
Jun 27, 2007
Last updated
Jan 26, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X MC04134 NJ Primary

Addresses

Primary practice location

1600 Saint Georges Ave
Ste 118
Rahway, NJ 07065-2764

Mailing address

1600 Saint Georges Ave
Ste 118
Rahway, NJ 07065-2764
Phone (732) 428-5566

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC04134NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Holsman Physical and Occupational Therapy PC CurrentSince Dec 5, 2014 Accepting new patients

Locations

1070 Clifton Ave
Ste 1A
Clifton, NJ 07013
Phone (973) 246-6565

711 Kearny Ave
#2
Kearny, NJ 07032
Phone (201) 535-8555

1600 Saint Georges Ave
Ste 107
Rahway, NJ 07065
Phone (732) 428-5566

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1447457114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SAINT GEORGES AVE",
            "address_2": "STE 118",
            "city": "RAHWAY",
            "state": "NJ",
            "postal_code": "070652764",
            "telephone_number": "732-428-5566",
            "fax_number": "732-428-5513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SAINT GEORGES AVE",
            "address_2": "STE 118",
            "city": "RAHWAY",
            "state": "NJ",
            "postal_code": "070652764",
            "telephone_number": "732-428-5566",
            "fax_number": "732-428-5513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGEORGE",
        "first_name": "MICHAEL",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-27",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "MC04134",
            "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 Jan 26, 2015; 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.