Individual provider Active NPI

Jeannine Cicchini, D.C.

  • Chiropractor
  • Blackwood, NJ
National Provider Identifier
1528282688
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00578900 Issued in NJ
Practice address
805 S Black Horse Pike
Blackwood, NJ 08012-2813
Phone
(856) 228-8888
Fax
(856) 228-9323
NPI assigned
Apr 12, 2007
Sex
Female
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 38MC00578900 NJ Primary

Addresses

Primary practice location

805 S Black Horse Pike
Blackwood, NJ 08012-2813

Mailing address

136 Sherwin Rd
Mullica Hill, NJ 08062-2427
Phone (856) 228-8888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120223000056 NJ Practitioner - Chiropractic 2466610324 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00578900NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Perry J Cicchini DC PA Chiropractor CurrentSince Jan 3, 2012 Accepting new patients

Locations

805 S Black Horse Pike
Blackwood, NJ 08012
Phone (856) 228-1330

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528282688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 SHERWIN RD",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080622427",
            "telephone_number": "856-228-8888",
            "fax_number": "856-228-9323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 S BLACK HORSE PIKE",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080122813",
            "telephone_number": "856-228-8888",
            "fax_number": "856-228-9323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICCHINI",
        "first_name": "JEANNINE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00578900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blackwood, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.