Organization Active NPI

Rise Chiropractic Inc

  • Chiropractor
  • Maple Shade, NJ
National Provider Identifier
1851893614
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00750600 Issued in NJ
Legal business name
RISE CHIROPRACTIC INC
Practice address
300 S Lenola Rd
Maple Shade, NJ 08052
Phone
(856) 733-0684
NPI assigned
Mar 7, 2018
Last updated
Jan 3, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Authorized official

Name
Dr. Shane Becker, DCNPI 1477055226
Title
Owner
Phone
(856) 733-0684

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
Chiropractor 111N00000X 38MC00750600 NJ Primary

Addresses

Primary practice location

300 S Lenola Rd
Maple Shade, NJ 08052

Mailing address

1605 Pennsauken St
Cinnaminson, NJ 08077-2620
Phone (267) 443-0684

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190404001684 NJ Part B Supplier - Clinic/Group Practice 9032123245 Receives reassigned benefits from 2 practitioners
Practice locations: Maple Shade, NJ

National Provider Directory

National Provider Directory

Locations

300 S Lenola Rd
Maple Shade, NJ 08052
Phone (856) 733-0684

Practitioners & affiliated clinicians

Practitioners 4

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": "1520380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546473600000",
    "number": "1851893614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 PENNSAUKEN ST",
            "city": "CINNAMINSON",
            "state": "NJ",
            "postal_code": "080772620",
            "telephone_number": "267-443-0684",
            "fax_number": "267-443-0684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S LENOLA RD",
            "city": "MAPLE SHADE",
            "state": "NJ",
            "postal_code": "08052",
            "telephone_number": "856-733-0684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISE CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-07",
        "last_updated": "2019-01-03",
        "status": "A",
        "authorized_official_last_name": "BECKER",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-733-0684",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00750600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Shade, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; 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.