NPIMap

Organization Active NPI

Oakland Spine and Physical Therapy of Wayne, LLC

  • Physical Therapist
  • Wayne, NJ
National Provider Identifier
1861270548
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
OAKLAND SPINE AND PHYSICAL THERAPY OF WAYNE, LLC
Practice address
1255 Hamburg Tpke
Wayne, NJ 07470-5071
Phone
(201) 651-9100
Fax
(201) 651-1142
NPI assigned
Sep 15, 2023
Last updated
Sep 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Authorized official

Name
Dr. Bradford Butler, DCNPI 1073650776
Title
Owner
Phone
(201) 651-9100

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1255 Hamburg Tpke
Wayne, NJ 07470-5071

Mailing address

9 Post Rd Ste M1
Oakland, NJ 07436-1615
Phone (201) 651-9100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240312002623 NJ Part B Supplier - Clinic/Group Practice 0749626877 Receives reassigned benefits from 10 practitioners
Practice locations: Wayne, NJ

National Provider Directory

National Provider Directory
Tax ID family
Chiropractic Works of Wayne LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

9 Post Rd
Ste M1
Oakland, NJ 07436
Phone (201) 337-9165

Practitioners & affiliated clinicians

Practitioners 10

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": "1694736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694736000000",
    "number": "1861270548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 POST RD STE M1",
            "city": "OAKLAND",
            "state": "NJ",
            "postal_code": "074361615",
            "telephone_number": "201-651-9100",
            "fax_number": "201-651-1142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 HAMBURG TPKE",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074705071",
            "telephone_number": "201-651-9100",
            "fax_number": "201-651-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKLAND SPINE AND PHYSICAL THERAPY OF WAYNE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-15",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "BRADFORD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-651-9100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; 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.