Individual provider Active NPI

John Patrick O'Connor III, D.C.

  • Chiropractor
  • Red Bank, NJ
National Provider Identifier
1508985730
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00595800 Issued in NJ
Practice address
231 Maple Ave
Red Bank, NJ 07701-1727
Phone
(732) 530-1164
Fax
(732) 530-2172
NPI assigned
Mar 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00595800 NJ Primary

Addresses

Primary practice location

231 Maple Ave
Red Bank, NJ 07701-1727

Mailing address

231 Maple Ave
Red Bank, NJ 07701-1727
Phone (732) 530-1164

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040427001388 NJ Practitioner - Chiropractic 2163419672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Velocity Chiropractic and Wellness Center, L.L.C.Group PAC ID 7416919808, 7 clinicians

Practice addresses (Care Compare)

231 Maple Ave
Red Bank, NJ 07701-1745
Phone (732) 530-1164

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00595800NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Velocity Chiropractic and Wellness Center, L.L.C. Chiropractor CurrentSince Jan 13, 2003 Accepting new patients

Locations

231 Maple Ave
Red Bank, NJ 07701
Phone (732) 530-1164

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": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508985730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 MAPLE AVE",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011727",
            "telephone_number": "732-530-1164",
            "fax_number": "732-530-2172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 MAPLE AVE",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011727",
            "telephone_number": "732-530-1164",
            "fax_number": "732-530-2172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "JOHN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00595800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bank, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.