Organization Active NPI

New Jersey Spine Institute, P.a.

  • Anesthesiology Physician
  • Bedminster, NJ
National Provider Identifier
1548412497
Registry record updated Oct 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
NEW JERSEY SPINE INSTITUTE, P.A.
Practice address
1 Robertson Dr
Bedminster, NJ 07921-1716
Phone
(908) 234-9200
Fax
(908) 234-2070
NPI assigned
Oct 22, 2008
Last updated
Oct 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2008

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

Authorized official

Name
Ms. Alexandra Archibald, MBA
Title
Administrator
Phone
(908) 722-0822

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NJ Primary

Addresses

Primary practice location

1 Robertson Dr
Bedminster, NJ 07921-1716

Mailing address

1 Robertson Dr
Bedminster, NJ 07921-1716
Phone (908) 234-9200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040517000408 NJ Part B Supplier - Clinic/Group Practice 0648260141 Receives reassigned benefits from 1 practitioner
Practice locations: Bedminster, NJ

National Provider Directory

National Provider Directory

Locations

1 Robertson Dr
Ste 11
Bedminster, NJ 07921
Phone (908) 234-9200

1 Robertson Dr
Ste 28
Bedminster, NJ 07921
Phone (908) 722-0822

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1224633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224633600000",
    "number": "1548412497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ROBERTSON DR",
            "city": "BEDMINSTER",
            "state": "NJ",
            "postal_code": "079211716",
            "telephone_number": "908-234-9200",
            "fax_number": "908-234-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ROBERTSON DR",
            "city": "BEDMINSTER",
            "state": "NJ",
            "postal_code": "079211716",
            "telephone_number": "908-234-9200",
            "fax_number": "908-234-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW JERSEY SPINE INSTITUTE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-22",
        "last_updated": "2008-10-22",
        "status": "A",
        "authorized_official_last_name": "ARCHIBALD",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "908-722-0822",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedminster, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2008; 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.