Active NPI
Realm Chiropractic, LLC
- Chiropractor
- Moosic, PA
National Provider Identifier
1720330137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 38MC00687100
- Legal business name
- REALM CHIROPRACTIC, LLC
- Practice address
- 73 Montage Mountain Road
Suite 3
Moosic, PA 18507 - Phone
- (570) 800-7991
- Fax
- (570) 909-9285
- NPI assigned
- Oct 9, 2012
- Organization subpart
- Yes
- Parent organization
- REALM CHIROPRACTIC, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Kristin D. Deeugenio, D.C.
- Title
- Owner/Chiropractor
- Phone
- (856) 305-8611
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 38MC00687100 | NJ | Primary |
Addresses
Primary practice location
73 Montage Mountain Road
Suite 3
Moosic, PA 18507
Mailing address
36 Bucky Run Lane
Thornhurst, PA 18424
Phone (856) 305-8611
National Provider Directory
National Provider Directory- Part of
- Realm Chiropractic LLC
Locations
557 Haddon Ave
Collingswood, NJ 08108
73 Montage Mountain Rd
Ste 3
Moosic, PA 18507
Phone (570) 800-7991
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Chiropractor
- Moosic, PA
- NPI 1588861330
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349740800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1693526400000",
"number": "1720330137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36 BUCKY RUN LANE",
"city": "THORNHURST",
"state": "PA",
"postal_code": "18424",
"telephone_number": "856-305-8611",
"fax_number": "856-854-4504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "73 MONTAGE MOUNTAIN ROAD",
"address_2": "SUITE 3",
"city": "MOOSIC",
"state": "PA",
"postal_code": "18507",
"telephone_number": "570-800-7991",
"fax_number": "570-909-9285"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "REALM CHIROPRACTIC, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "REALM CHIROPRACTIC, LLC",
"enumeration_date": "2012-10-09",
"last_updated": "2023-09-01",
"status": "A",
"authorized_official_last_name": "DEEUGENIO",
"authorized_official_first_name": "KRISTIN",
"authorized_official_middle_name": "D.",
"authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
"authorized_official_telephone_number": "856-305-8611",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.C."
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "NJ",
"license": "38MC00687100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moosic, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.