NPIMap

Organization Active NPI

Source Wellness Center of Metuchen LLC

  • Chiropractor
  • Metuchen, NJ
National Provider Identifier
1841935137
Registry record updated May 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SOURCE WELLNESS CENTER OF METUCHEN LLC
Practice address
173 Essex Ave Ste 103
Metuchen, NJ 08840-2281
Phone
(732) 978-0951
NPI assigned
May 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2022

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

Authorized official

Name
Dr. Kyle Bilquist, D.C.NPI 1164870143
Title
Owner
Phone
(732) 978-0951

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: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

173 Essex Ave Ste 103
Metuchen, NJ 08840-2281

Mailing address

1204 Laurel Ave
Sea Girt, NJ 08750-2410

National Provider Directory

National Provider Directory

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": "1651363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651363200000",
    "number": "1841935137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 LAUREL AVE",
            "city": "SEA GIRT",
            "state": "NJ",
            "postal_code": "087502410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 ESSEX AVE STE 103",
            "city": "METUCHEN",
            "state": "NJ",
            "postal_code": "088402281",
            "telephone_number": "732-978-0951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOURCE WELLNESS CENTER OF METUCHEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-01",
        "last_updated": "2022-05-01",
        "certification_date": "2022-05-01",
        "status": "A",
        "authorized_official_last_name": "BILQUIST",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-978-0951",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metuchen, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2022; 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.