NPIMap

Organization Active NPI

South Orange Chiropractic Center

  • Chiropractor
  • South Orange, NJ
National Provider Identifier
1669612628
Registry record updated Oct 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MC 03031 Issued in NJ
Legal business name
SOUTH ORANGE CHIROPRACTIC CENTER
Practice address
60 1St St
South Orange, NJ 07079-1916
Phone
(973) 761-0022
Fax
(973) 761-1546
NPI assigned
Mar 3, 2009
Last updated
Oct 9, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2009

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

Authorized official

Name
Stephen J Levine, D.C.NPI 1760492920
Title
Owner
Phone
(973) 761-0022

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X MC 03031 NJ Primary

Addresses

Primary practice location

60 1St St
South Orange, NJ 07079-1916

Mailing address

60 1St St
South Orange, NJ 07079-1916
Phone (973) 761-0022

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090427000187 NJ Part B Supplier - Clinic/Group Practice 6406904762 Receives reassigned benefits from 16 practitioners
Practice locations: South Orange, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255046400000",
    "number": "1669612628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 1ST ST",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070791916",
            "telephone_number": "973-761-0022",
            "fax_number": "973-761-1546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 1ST ST",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070791916",
            "telephone_number": "973-761-0022",
            "fax_number": "973-761-1546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ORANGE CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-03",
        "last_updated": "2009-10-09",
        "status": "A",
        "authorized_official_last_name": "LEVINE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-761-0022",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "MC 03031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2009; 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.