Organization Active NPI

Dynamic Chiropractic

  • Chiropractor
  • Sicklerville, NJ
National Provider Identifier
1700812880
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
DYNAMIC CHIROPRACTIC
Practice address
817 Erial New Brooklyn Road
Sicklerville, NJ 08081-3278
Phone
(856) 782-2077
Fax
(856) 782-2078
NPI assigned
Jun 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jason Cerutti, DC
Title
DC Owner
Phone
(856) 782-2077

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

817 Erial New Brooklyn Road
Sicklerville, NJ 08081-3278

Mailing address

817 Erial New Brooklyn Road
Sicklerville, NJ 08081-3278
Phone (856) 782-2077

Other identifiers 2

IdentifierTypeStateIssuer
0189715000OtherAMERIHEALTH HMO
802949OtherAMERIHEALTH PPO

National Provider Directory

National Provider Directory

Locations

817 New Brooklyn Erial Rd
Sicklerville, NJ 08081
Phone (856) 782-2077

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700812880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 ERIAL NEW BROOKLYN ROAD",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080813278",
            "telephone_number": "856-782-2077",
            "fax_number": "856-782-2078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 ERIAL NEW BROOKLYN ROAD",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080813278",
            "telephone_number": "856-782-2077",
            "fax_number": "856-782-2078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CERUTTI",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "DC OWNER",
        "authorized_official_telephone_number": "856-782-2077",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH HMO",
            "identifier": "0189715000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH PPO",
            "identifier": "802949",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sicklerville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.