Optimal Health Family Chiropractic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00729600 Issued in NJ

Legal business name

OPTIMAL HEALTH FAMILY CHIROPRACTIC, LLC

Practice address

17 Hawthorne Ave
Park Ridge, NJ 07656-1212

Phone

(201) 505-8984

Fax

(201) 505-8986

NPI assigned

Dec 10, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Andrew O'Neill, D.C.NPI 1124492343

Title

Managing Member

Phone

(201) 505-8984

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrew O'Neill, D.C.

  • Chiropractor
  • Park Ridge, NJ
  • NPI 1124492343
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455062400000",
    "number": "1982079232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 HAWTHORNE AVE",
            "city": "PARK RIDGE",
            "state": "NJ",
            "postal_code": "076561212",
            "telephone_number": "201-505-8984",
            "fax_number": "201-505-8986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 HAWTHORNE AVE",
            "city": "PARK RIDGE",
            "state": "NJ",
            "postal_code": "076561212",
            "telephone_number": "201-505-8984",
            "fax_number": "201-505-8986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL HEALTH FAMILY CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-10",
        "last_updated": "2016-02-10",
        "status": "A",
        "authorized_official_last_name": "O'NEILL",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "201-505-8984",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00729600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "470469",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Morgan, OTR
• Tara Nelsen-Defalco
• New Concepts for Living
• Andrew O'Neill, D.C.
• Charles Wold Olsen Jr., D.M.D.
• Park Ridge Al Amop, LLC
• Park Ridge Board of Education
• Park Ridge Chiropractic
• Park Ridge Geriatrics PC
• Park Ridge Healthcare SNF, LLC

• Chiropractor in Park Ridge, NJ
• Providers in Park Ridge, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2016; 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.