Organization Active NPI

Pine Cone Chiropractic

  • Chiropractor
  • Sparta, NJ
National Provider Identifier
1710176672
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MC05169 Issued in NJ
Legal business name
PINE CONE CHIROPRACTIC
Practice address
10 Pine Cone Lane
Sparta, NJ 07871-2302
Phone
(973) 729-5251
Fax
(972) 729-1431
NPI assigned
Oct 17, 2007
Last updated
Oct 17, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Authorized official

Name
Anne M Odair, DCNPI 1285650689
Title
Owner Chiropractor
Phone
(973) 729-5251

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 MC05169 NJ Primary
Chiropractor 111N00000X MC04860 NJ

Addresses

Primary practice location

10 Pine Cone Lane
Sparta, NJ 07871-2302

Mailing address

10 Pine Cone Lane
Sparta, NJ 07871-2302
Phone (973) 729-5251

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050323000992 NJ Part B Supplier - Clinic/Group Practice 4082660055 Receives reassigned benefits from 2 practitioners
Practice locations: Sparta, NJ

National Provider Directory

National Provider Directory

Locations

10 Pine Cone Ln
Sparta, NJ 07871
Phone (973) 729-5251

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": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1710176672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PINE CONE LANE",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078712302",
            "telephone_number": "973-729-5251",
            "fax_number": "972-729-1431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PINE CONE LANE",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078712302",
            "telephone_number": "973-729-5251",
            "fax_number": "972-729-1431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE CONE CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-17",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "ODAIR",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER CHIROPRACTOR",
        "authorized_official_telephone_number": "973-729-5251",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "MC05169",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "MC04860",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparta, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; 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.