Organization Active NPI

Spine and Sports Rehab. Institute

  • Chiropractor
  • Wall, NJ
National Provider Identifier
1952472458
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00311800 Issued in NJ
Legal business name
SPINE AND SPORTS REHAB. INSTITUTE
Practice address
1800 State Route 34
Bldge # 3
Wall, NJ 07719-9168
Phone
(732) 223-5550
Fax
(732) 280-0233
NPI assigned
Nov 13, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Guy Donner, D.C.NPI 1770693590
Title
Owner
Phone
(732) 223-5550

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
Chiropractor 111N00000X 38MC00311800 NJ Primary

Addresses

Primary practice location

1800 State Route 34
Bldge # 3
Wall, NJ 07719-9168

Mailing address

1800 State Route 34
Bldge # 3
Wall, NJ 07719-9168
Phone (732) 223-5550

National Provider Directory

National Provider Directory

Locations

1800 State Route 34
Bldg 3
Wall Township, NJ 07719
Phone (732) 223-5550

Practitioners & affiliated clinicians

Practitioners 3

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": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952472458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 STATE ROUTE 34",
            "address_2": "BLDGE # 3",
            "city": "WALL",
            "state": "NJ",
            "postal_code": "077199168",
            "telephone_number": "732-223-5550",
            "fax_number": "732-280-0233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 STATE ROUTE 34",
            "address_2": "BLDGE # 3",
            "city": "WALL",
            "state": "NJ",
            "postal_code": "077199168",
            "telephone_number": "732-223-5550",
            "fax_number": "732-280-0233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE AND SPORTS REHAB. INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DONNER",
        "authorized_official_first_name": "GUY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-223-5550",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00311800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wall, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.