Organization Active NPI

South Jersey Wellness Group

  • Chiropractor
  • Cherry Hill, NJ
National Provider Identifier
1902442064
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SOUTH JERSEY WELLNESS GROUP
Practice address
1919 Greentree Rd
Cherry Hill, NJ 08003-1115
Phone
(856) 761-8100
NPI assigned
Nov 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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

Authorized official

Name
Lynette Contreni Bernier
Title
Billing Manager
Phone
(973) 764-9685

Specialties & licenses 1

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

Addresses

Primary practice location

1919 Greentree Rd
Cherry Hill, NJ 08003-1115

Mailing address

1919 Greentree Rd
Cherry Hill, NJ 08003-1115
Phone (856) 761-8100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200127002227 NJ Part B Supplier - Clinic/Group Practice 4587099247 Receives reassigned benefits from 1 practitioner
Practice locations: Cherry Hill, NJ

National Provider Directory

National Provider Directory

Locations

1919 Greentree Rd
Cherry Hill, NJ 08003
Phone (856) 761-8100

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": "1574640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574640000000",
    "number": "1902442064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 GREENTREE RD",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080031115",
            "telephone_number": "856-761-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 GREENTREE RD",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080031115",
            "telephone_number": "856-761-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH JERSEY WELLNESS GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-25",
        "last_updated": "2019-11-25",
        "status": "A",
        "authorized_official_last_name": "CONTRENI BERNIER",
        "authorized_official_first_name": "LYNETTE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "973-764-9685"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.