Organization Active NPI

Mullica Hill Chiropractic

  • Chiropractor
  • Mullica Hill, NJ
National Provider Identifier
1770600520
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00569800 Issued in NJ
Legal business name
MULLICA HILL CHIROPRACTIC
Practice address
47 Woodstown Rd
Mullica Hill, NJ 08062
Phone
(856) 223-5876
Fax
(856) 223-8615
NPI assigned
Mar 26, 2007
Last updated
Feb 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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

Authorized official

Name
Dr. Kevin P Smith, D.C.NPI 1861589764
Title
Director
Phone
(856) 223-5876

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)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 38MC00569800 NJ Primary

Addresses

Primary practice location

47 Woodstown Rd
Mullica Hill, NJ 08062

Mailing address

47 Woodstown Rd
PO Box 412
Mullica Hill, NJ 08062
Phone (856) 223-5876

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161103000831 NJ Part B Supplier - Clinic/Group Practice 2163700600 Receives reassigned benefits from 1 practitioner
Practice locations: Mullica Hill, NJ

National Provider Directory

National Provider Directory

Locations

33 S Main St
Mullica Hill, NJ 08062
Phone (856) 223-5876

47 Woodstown Rd
Mullica Hill, NJ 08062
Phone (856) 223-5876

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612483200000",
    "number": "1770600520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 WOODSTOWN RD",
            "address_2": "PO BOX 412",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "08062",
            "telephone_number": "856-223-5876",
            "fax_number": "856-223-8615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 WOODSTOWN RD",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "08062",
            "telephone_number": "856-223-5876",
            "fax_number": "856-223-8615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULLICA HILL CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "856-223-5876",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00569800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mullica Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.