Revolution Chiropractic Health Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00687000 Issued in NJ

Legal business name

REVOLUTION CHIROPRACTIC HEALTH CENTER

Doing business as

Freedom Chiropractic

Practice address

4516 Church Rd
Mount Laurel, NJ 08054-2210

Phone

(856) 552-0570

Fax

(856) 988-1159

NPI assigned

Apr 18, 2011

Last updated

Aug 25, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Devon Matthew Coughlin, D.C.NPI 1104126267

Title

Owner

Phone

(609) 668-5456

Specialties & licenses 1

Addresses

Other names 1

• Freedom Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

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.

• Devon Matthew Coughlin, D.C.

  • Chiropractor
  • Mount Laurel, NJ
  • NPI 1104126267
  Medicare reassignment NPD Authorized official
• David L Jones, DC

  • Chiropractor
  • Mount Laurel, NJ
  • NPI 1528147899
  NPD
• Ronald D Peak, D.C.

  • Chiropractor
  • Mount Laurel, NJ
  • NPI 1487842555
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1303084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692921600000",
    "number": "1952691495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4516 CHURCH RD",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080542210",
            "telephone_number": "856-552-0570",
            "fax_number": "856-988-1159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4516 CHURCH RD",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080542210",
            "telephone_number": "856-552-0570",
            "fax_number": "856-988-1159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVOLUTION CHIROPRACTIC HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-18",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A",
        "authorized_official_last_name": "COUGHLIN",
        "authorized_official_first_name": "DEVON",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-668-5456",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00687000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Freedom Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rem New Jersey, Inc.
• Res-Care New Jersey, Inc.
• Res-Care New Jersey, Inc.
• Res-Care New Jersey, Inc.
• Jennifer Dawn Resnick Matro
• Rha Health Services NJ LLC
• Rha Health Services NJ LLC
• Walter J Rhoades, D.O.
• Lorri Rice
• Christie Sleigher Richardson, DO

• Chiropractor in Mount Laurel, NJ
• Providers in Mount Laurel, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.