Individual provider Active NPI

Geoffrey C Ellington, D.C.

  • Chiropractor
  • Pennsville, NJ
National Provider Identifier
1508910753
Registry record updated Aug 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00361200 Issued in NJ
Practice address
390 N Broadway Ste 300
Pennsville, NJ 08070-1253
Phone
(856) 678-5975
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00361200 NJ Primary

Addresses

Primary practice location

390 N Broadway Ste 300
Pennsville, NJ 08070-1253

Mailing address

390 N Broadway Ste 300
Pennsville, NJ 08070-1253
Phone (856) 678-5975

Other identifiers 1

IdentifierTypeStateIssuer
30815OtherAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041207000986 NJ Practitioner - Chiropractic 1850357229 Practice locations: Pennsville, NJ

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

390 N Broadway
Suite 300
Pennsville, NJ 08070-1253
Phone (856) 678-5975

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00361200NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Shields and Shields PC PastSince Aug 9, 2022 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1508910753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 N BROADWAY STE 300",
            "city": "PENNSVILLE",
            "state": "NJ",
            "postal_code": "080701253",
            "telephone_number": "856-678-5975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 N BROADWAY STE 300",
            "city": "PENNSVILLE",
            "state": "NJ",
            "postal_code": "080701253",
            "telephone_number": "856-678-5975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLINGTON",
        "first_name": "GEOFFREY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00361200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "30815",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pennsville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; 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.