Organization Active NPI

Total Wellness of NJ, Inc.

  • Chiropractor
  • Lake Hopatcong, NJ
National Provider Identifier
1871654723
Registry record updated Jul 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MC05066 Issued in NJ
Legal business name
TOTAL WELLNESS OF NJ, INC.
Practice address
28 Bowling Green Pkwy Ste 1a
Lake Hopatcong, NJ 07849
Phone
(973) 663-5633
Fax
(973) 663-5762
NPI assigned
Dec 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2018

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

Authorized official

Name
Leah Petito
Title
Office Manager
Phone
(973) 663-5633

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X MC05066 NJ Primary

Addresses

Primary practice location

28 Bowling Green Pkwy Ste 1a
Lake Hopatcong, NJ 07849

Mailing address

28 Bowling Green Pkwy Ste 1a
Lake Hopatcong, NJ 07849-2445
Phone (973) 663-5633

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120702000287 NJ Part B Supplier - Clinic/Group Practice 6608031380 Receives reassigned benefits from 2 practitioners
Practice locations: Lake Hopatcong, NJ

National Provider Directory

National Provider Directory

Locations

28 Bowling Green Pkwy
Ste 1A
Lake Hopatcong, NJ 07849
Phone (973) 663-5633

21 Bowling Green Pkwy
Ste 201
Lk Hopatcong, NJ 07849
Phone (973) 663-5633

Practitioners & affiliated clinicians

Practitioners 3

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": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530489600000",
    "number": "1871654723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 BOWLING GREEN PKWY STE 1A",
            "city": "LAKE HOPATCONG",
            "state": "NJ",
            "postal_code": "078492445",
            "telephone_number": "973-663-5633",
            "fax_number": "973-663-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 BOWLING GREEN PKWY STE 1A",
            "city": "LAKE HOPATCONG",
            "state": "NJ",
            "postal_code": "07849",
            "telephone_number": "973-663-5633",
            "fax_number": "973-663-5762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL WELLNESS OF NJ, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2018-07-02",
        "status": "A",
        "authorized_official_last_name": "PETITO",
        "authorized_official_first_name": "LEAH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "973-663-5633"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "MC05066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Hopatcong, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; 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.