NPIMap

Organization Active NPI

Sports Medicine Center of Bergen, PA

  • Physical Therapist
  • Livingston, NJ
National Provider Identifier
1780158758
Registry record updated Jan 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SPORTS MEDICINE CENTER OF BERGEN, PA
Practice address
555 S Livingston Ave
Livingston, NJ 07039-5410
Phone
(201) 488-0488
NPI assigned
Jan 14, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2019

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

Authorized official

Name
Kimberly Hunter
Title
Admin MGR
Phone
(201) 488-0488

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

555 S Livingston Ave
Livingston, NJ 07039-5410

Mailing address

605 Main St
Hackensack, NJ 07601-5914
Phone (201) 488-0488

Other names 1

  • Excel Orthopedic Rehabilitation Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Excel Orthopedic Rehabi8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1547424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547424000000",
    "number": "1780158758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 MAIN ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076015914",
            "telephone_number": "201-488-0488",
            "fax_number": "201-343-5325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S LIVINGSTON AVE",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395410",
            "telephone_number": "201-488-0488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS MEDICINE CENTER OF BERGEN, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-14",
        "last_updated": "2019-01-14",
        "status": "A",
        "authorized_official_last_name": "HUNTER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "ADMIN MGR",
        "authorized_official_telephone_number": "201-488-0488"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excel Orthopedic Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Livingston, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2019; 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.