Individual provider Active NPI

Jody Lawrence Serra, DC

  • Chiropractor
  • Lebanon, NJ
National Provider Identifier
1609949593
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00236400 Issued in NJ
Practice address
1356 US Hwy 22 West
Lebanon, NJ 08833
Phone
(908) 236-6353
Fax
(908) 236-7038
NPI assigned
Nov 16, 2006
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 38MC00236400 NJ Primary

Addresses

Primary practice location

1356 US Hwy 22 West
Lebanon, NJ 08833

Mailing address

1356 US Hwy 22 West
Lebanon, NJ 08833
Phone (908) 236-6353

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120214000167 NJ Practitioner - Chiropractic 8527052679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1386 US Hwy 22 W
Lebanon, NJ 08833
Phone (908) 236-6353

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Natural Health and Rehabilitation Inc Chiropractor CurrentSince Sep 26, 2011 Accepting new patients
Center for Natural Health and Rehabilitation Chiropractor Past Accepting new patients

Locations

1386 US Highway 22
Lebanon, NJ 08833
Phone (908) 236-6353

Organizations & group practices 2

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609949593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1356 US HWY 22 WEST",
            "city": "LEBANON",
            "state": "NJ",
            "postal_code": "08833",
            "telephone_number": "908-236-6353",
            "fax_number": "908-236-7038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1356 US HWY 22 WEST",
            "city": "LEBANON",
            "state": "NJ",
            "postal_code": "08833",
            "telephone_number": "908-236-6353",
            "fax_number": "908-236-7038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRA",
        "first_name": "JODY",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00236400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, 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.