Individual provider Active NPI

Ellen R Thomas, D.C.

  • Sports Physician Chiropractor
  • Moorestown, NJ
National Provider Identifier
1861447476
Registry record updated Jun 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
38MC00249200 Issued in NJ
Practice address
1221 N Church St
Suite 203
Moorestown, NJ 08057-1245
Phone
(843) 368-4252
Fax
(856) 608-8851
NPI assigned
May 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 38MC00249200 NJ Primary

Addresses

Primary practice location

1221 N Church St
Suite 203
Moorestown, NJ 08057-1245

Mailing address

26 Woodside LN
Cinnaminson, NJ 08077-2462
Phone (843) 368-4252

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131114000282 NJ Practitioner - Chiropractic 4587558747 Practice locations: Moorestown, NJ

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

704 E Main St
Suite B
Moorestown, NJ 08057-3070
Phone (856) 242-9706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00249200NJMDSports Physician Chiropractor
2827SCMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Spine LLC Past Accepting new patients
Thomas Fittness Associates LLC PastSince Feb 10, 2004 Accepting new patients

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1861447476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 WOODSIDE LN",
            "city": "CINNAMINSON",
            "state": "NJ",
            "postal_code": "080772462",
            "telephone_number": "843-368-4252",
            "fax_number": "856-608-8851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 N CHURCH ST",
            "address_2": "SUITE 203",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080571245",
            "telephone_number": "843-368-4252",
            "fax_number": "856-608-8851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "ELLEN",
        "middle_name": "R",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NJ",
            "license": "38MC00249200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorestown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.