Individual provider Active NPI

Carmine Joseph Gangemi III, D.C.

  • Chiropractor
  • Dover, NJ
National Provider Identifier
1821167040
Registry record updated Sep 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00776900 Issued in NJ
Practice address
369 W Blackwell St Ste 2
Dover, NJ 07801-2560
Phone
(973) 343-6633
Fax
(973) 343-6633
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 38MC00776900 NJ Primary

Addresses

Primary practice location

369 W Blackwell St Ste 2
Dover, NJ 07801-2560

Mailing address

369 W Blackwell St Ste 2
Dover, NJ 07801-2560
Phone (973) 343-6633

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211014000530 NJ Practitioner - Chiropractic 0446658934

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gangemi Chiropractic LLC Chiropractor CurrentSince Aug 18, 2021 Accepting new patients
Advanced Chiropractic & Spinal Rehab. Chiropractor Past Accepting new patients

Locations

369 W Blackwell St
Ste 2
Dover, NJ 07801
Phone (310) 985-0903

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631923200000",
    "number": "1821167040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "369 W BLACKWELL ST STE 2",
            "city": "DOVER",
            "state": "NJ",
            "postal_code": "078012560",
            "telephone_number": "973-343-6633",
            "fax_number": "973-343-6633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 W BLACKWELL ST STE 2",
            "city": "DOVER",
            "state": "NJ",
            "postal_code": "078012560",
            "telephone_number": "973-343-6633",
            "fax_number": "973-343-6633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANGEMI",
        "first_name": "CARMINE",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2021-09-18",
        "certification_date": "2021-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00776900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NJ

Sources for this page

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