Individual provider Active NPI

David J. Wunder, DC

  • Chiropractor
  • Union, NJ
National Provider Identifier
1750453692
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00477300 Issued in NJ
Practice address
410 Chestnut St
Union, NJ 07083-9306
Phone
(908) 624-9000
NPI assigned
Nov 15, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00477300 NJ Primary

Addresses

Primary practice location

410 Chestnut St
Union, NJ 07083-9306

Mailing address

410 Chestnut St
Union, NJ 07083-9306
Phone (908) 624-9000

Other identifiers 2

IdentifierTypeStateIssuer
U78537OtherNJMEDICARE DR. ID# BOX 17A
7129009MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041104000028 NJ Practitioner - Chiropractic 4385606060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Hwy 12
Suite 303
Flemington, NJ 08822-7702
Phone (908) 788-1714

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wunder Chiropractic Life Center, LLC Chiropractor CurrentSince Sep 1, 1999 Accepting new patients
Hilliard Chiropractic Center, LLC Chiropractor Past Accepting new patients

Locations

1 Highway 12
Ste 303
Flemington, NJ 08822
Phone (908) 788-1714

Organizations & group practices 2

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750453692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 CHESTNUT ST",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070839306",
            "telephone_number": "908-624-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 CHESTNUT ST",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070839306",
            "telephone_number": "908-624-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUNDER",
        "first_name": "DAVID",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00477300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DR. ID# BOX 17A",
            "identifier": "U78537",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7129009",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.