Super Chiropractic Life Center LLP

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

SUPER CHIROPRACTIC LIFE CENTER LLP

Practice address

2 Lees LN
Haddon Township, NJ 08107-1091

Phone

(856) 858-5511

Fax

(856) 858-2317

NPI assigned

Feb 11, 2021

Organization subpart

No

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

Authorized official

Name

Gwendolyn Super

Title

Office Manager

Phone

(856) 858-5511

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Andrew Super, DC

  • Chiropractor
  • Haddon Township, NJ
  • NPI 1720080708
  Medicare reassignment Care Compare group NPD
• Casandra Leigh Super, DC

  • Chiropractor
  • Haddon Township, NJ
  • NPI 1639761562
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1613001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613606400000",
    "number": "1750973673",
    "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": {
        "organization_name": "SUPER CHIROPRACTIC LIFE CENTER LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-11",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A",
        "authorized_official_last_name": "SUPER",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "856-858-5511"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hilda Andrea Smits, LPC
• Solaryan LLC
• South Jersey Sports Chiropractic
• Elena Stavisky, D.M.D.
• Joann Stettler, D.M.D.
• Casandra Leigh Super, DC
• Robert Andrew Super, DC
• Tara Brophy LLC
• Cameron Teague
• Gregory Thielman

• 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 Feb 18, 2021; 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.