Organization Active NPI

Lafayette Street Chiropractic Center PC

  • Chiropractor
  • Newark, NJ
National Provider Identifier
1942237995
Registry record updated Aug 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00539100 Issued in NJ
Legal business name
LAFAYETTE STREET CHIROPRACTIC CENTER PC
Practice address
123 Clifford St., Ste 105
Newark, NJ 07105
Phone
(973) 466-3810
NPI assigned
Jun 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2007

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

Authorized official

Name
Dr. Jesse J Burrini Jr., D.C.NPI 1457388381
Title
President
Phone
(973) 466-3810

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 38MC00539100 NJ Primary

Addresses

Primary practice location

123 Clifford St., Ste 105
Newark, NJ 07105

Mailing address

123 Clifford Street, Suite 105
Newark, NJ 07105
Phone (973) 466-3810

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070802000391 NJ Part B Supplier - Clinic/Group Practice 3577654722 Receives reassigned benefits from 1 practitioner
Practice locations: Newark, NJ

National Provider Directory

National Provider Directory

Locations

123 Clifford St
Ste 105
Newark, NJ 07105
Phone (973) 466-3810

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": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186012800000",
    "number": "1942237995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 CLIFFORD STREET, SUITE 105",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07105",
            "telephone_number": "973-466-3810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 CLIFFORD ST., STE 105",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07105",
            "telephone_number": "973-466-3810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAFAYETTE STREET CHIROPRACTIC CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2007-08-02",
        "status": "A",
        "authorized_official_last_name": "BURRINI",
        "authorized_official_first_name": "JESSE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-466-3810",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00539100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2007; 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.