NPIMap

Organization Active NPI

Innovative Wellness Center PC

  • Chiropractor
  • Jamesburg, NJ
National Provider Identifier
1619019544
Registry record updated May 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
INNOVATIVE WELLNESS CENTER PC
Practice address
220 Forsgate Dr
Jamesburg, NJ 08831-1375
Phone
(732) 656-1740
Fax
(732) 656-1742
NPI assigned
Feb 14, 2007
Last updated
May 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2011

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

Authorized official

Name
Dr. Bryan Scott Berger, DCNPI 1356357446
Title
Chiropractor
Phone
(732) 656-1740

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary
Acupuncturist 171100000X NU

Addresses

Primary practice location

220 Forsgate Dr
Jamesburg, NJ 08831-1375

Mailing address

220 Forsgate Dr
Jamesburg, NJ 08831-1375
Phone (732) 656-1740

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070312000025 NJ Part B Supplier - Clinic/Group Practice 8729181854 Receives reassigned benefits from 4 practitioners
Practice locations: Jamesburg, NJ

National Provider Directory

National Provider Directory

Locations

220 Forsgate Dr
Jamesburg, NJ 08831
Phone (732) 656-1740

Practitioners & affiliated clinicians

Practitioners 11

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": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304899200000",
    "number": "1619019544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 FORSGATE DR",
            "city": "JAMESBURG",
            "state": "NJ",
            "postal_code": "088311375",
            "telephone_number": "732-656-1740",
            "fax_number": "732-656-1742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 FORSGATE DR",
            "city": "JAMESBURG",
            "state": "NJ",
            "postal_code": "088311375",
            "telephone_number": "732-656-1740",
            "fax_number": "732-656-1742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE WELLNESS CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2011-05-09",
        "status": "A",
        "authorized_official_last_name": "BERGER",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "732-656-1740",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamesburg, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2011; 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.