Organization Active NPI

Kinnelon Medical & Wellness Associates LLC

  • Physical Therapist
  • Kinnelon, NJ
National Provider Identifier
1770856197
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
KINNELON MEDICAL & WELLNESS ASSOCIATES LLC
Practice address
300 Kakeout Rd
Suite C
Kinnelon, NJ 07405-2548
Phone
(973) 838-6252
Fax
(973) 838-4159
NPI assigned
Feb 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Authorized official

Name
Paul Marston, DCNPI 1659305290
Title
Owner
Phone
(973) 838-6252

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
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

300 Kakeout Rd
Suite C
Kinnelon, NJ 07405-2548

Mailing address

300 Kakeout Road
Suite C
Kinnelon, NJ 07405-2548
Phone (973) 838-6252

National Provider Directory

National Provider Directory

Locations

300 Kakeout Rd
#A
Kinnelon, NJ 07405

300 Kakeout Rd
Ste C
Kinnelon, NJ 07405
Phone (973) 838-6252

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1770856197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 KAKEOUT ROAD",
            "address_2": "SUITE C",
            "city": "KINNELON",
            "state": "NJ",
            "postal_code": "074052548",
            "telephone_number": "973-838-6252",
            "fax_number": "973-838-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 KAKEOUT RD",
            "address_2": "SUITE C",
            "city": "KINNELON",
            "state": "NJ",
            "postal_code": "074052548",
            "telephone_number": "973-838-6252",
            "fax_number": "973-838-4159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINNELON MEDICAL & WELLNESS ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-15",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "MARSTON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-838-6252",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kinnelon, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.