Robert Andrew Super, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00375100 Issued in NJ

Practice address

2 Lees LN
Haddon Township, NJ 08107-1091

Phone

(856) 858-5511

Fax

(856) 858-2317

NPI assigned

Aug 10, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Super Chiropractic Life Center LLPGroup PAC ID 3870900236, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Super Chiropractic Life Center LLP

  • Chiropractor
  • Haddon Township, NJ
  • NPI 1750973673
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378944000000",
    "number": "1720080708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 LEES LN",
            "city": "HADDON TOWNSHIP",
            "state": "NJ",
            "postal_code": "081071091",
            "telephone_number": "856-858-5511",
            "fax_number": "856-858-2317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 LEES LN",
            "city": "HADDON TOWNSHIP",
            "state": "NJ",
            "postal_code": "081071091",
            "telephone_number": "856-858-5511",
            "fax_number": "856-858-2317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPER",
        "first_name": "ROBERT",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2013-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00375100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Jersey Sports Chiropractic
• Elena Stavisky, D.M.D.
• Joann Stettler, D.M.D.
• Super Chiropractic Life Center LLP
• Casandra Leigh Super, DC
• Tara Brophy LLC
• Cameron Teague
• Gregory Thielman
• Sharon Denise Thomas, MS, LPC, NCC
• Samuel Irving Tilonsky, O.D.

• Chiropractor in Haddon Township, NJ
• Providers in Haddon Township, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; 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.