Individual provider Active NPI

William M Ross, D.C.

  • Sports Physician Chiropractor
  • Galloway, NJ
National Provider Identifier
1710926175
Registry record updated Feb 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
38MC00569700 Issued in NJ
Practice address
319 E Jimmie Leeds Rd Ste 104
Galloway, NJ 08205-4136
Phone
(609) 748-1099
Fax
(609) 748-1216
NPI assigned
Jun 4, 2006
Last updated
Feb 16, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 38MC00569700 NJ Primary

Addresses

Primary practice location

319 E Jimmie Leeds Rd Ste 104
Galloway, NJ 08205-4136

Mailing address

160 S New York Rd
Suite C4
Galloway, NJ 08205-9608
Phone (609) 748-1099

Other identifiers 1

IdentifierTypeStateIssuer
9130802MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070530000018 NJ Practitioner - Chiropractic 1951408814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

160 S New York Rd
Suite C4
Galloway, NJ 08205-9608
Phone (609) 748-1099

319 E Jimmie Leeds Rd
Suite 104
Galloway, NJ 08205-4124
Phone (609) 748-1099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00569700NJMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Bill Ross, DC, LLC Sports Physician CurrentSince Aug 31, 2000 Accepting new patients

Locations

160 S New York Rd
#C4
Galloway, NJ 08205
Phone (609) 748-1099

319 E Jimmie Leeds Rd
Ste 104
Galloway, NJ 08205
Phone (609) 748-1099

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1710926175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 S NEW YORK RD",
            "address_2": "SUITE C4",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059608",
            "telephone_number": "609-748-1099",
            "fax_number": "609-748-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 E JIMMIE LEEDS RD STE 104",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082054136",
            "telephone_number": "609-748-1099",
            "fax_number": "609-748-1216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "WILLIAM",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NJ",
            "license": "38MC00569700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9130802",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galloway, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; 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.