Individual provider Active NPI

Chinonyerem Ikenna Ejiofor, D.C.

  • Chiropractor
  • Secaucus, NJ
National Provider Identifier
1538548466
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00724700 Issued in NJ
Practice address
1255 Paterson Plank Rd
Secaucus, NJ 07094-3247
Phone
(201) 293-4697
Fax
(201) 552-2245
NPI assigned
May 26, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00724700 NJ Primary

Addresses

Primary practice location

1255 Paterson Plank Rd
Secaucus, NJ 07094-3247

Mailing address

1255 Paterson Plank Rd
Secaucus, NJ 07094-3247
Phone (201) 293-4697

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161020001165 NJ Practitioner - Chiropractic 5597043802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chirolove Spine and Wellness Center LLCGroup PAC ID 4385975788, 2 clinicians

Practice addresses (Care Compare)

1255 Paterson Plank Rd
Secaucus, NJ 07094-3247
Phone (201) 293-4697

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00724700NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chirolove Spine & Wellness Center LLC Chiropractor CurrentSince Mar 29, 2023 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": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1538548466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 PATERSON PLANK RD",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070943247",
            "telephone_number": "201-293-4697",
            "fax_number": "201-552-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 PATERSON PLANK RD",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070943247",
            "telephone_number": "201-293-4697",
            "fax_number": "201-552-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EJIOFOR",
        "first_name": "CHINONYEREM",
        "middle_name": "IKENNA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-26",
        "last_updated": "2023-07-06",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00724700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Secaucus, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; 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.