Kennedy Wellness Center Corp

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00695200 Issued in NJ

Legal business name

KENNEDY WELLNESS CENTER CORP

Practice address

400 38TH Street
Suite 302
Union City, NJ 07087

Phone

(201) 766-8222

Fax

(201) 766-8221

NPI assigned

Feb 21, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Philip Estrada, DCNPI 1598753592

Title

Doctor/Owner

Phone

(201) 766-8222

Specialties & licenses 1

Addresses

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.

• Philip Raul Estrada, D.C.

  • Chiropractor
  • Union City, NJ
  • NPI 1598753592
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663718400000",
    "number": "1992045389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 38TH STREET",
            "address_2": "SUITE 302",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "07087",
            "telephone_number": "201-766-8222",
            "fax_number": "201-766-8221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 38TH STREET",
            "address_2": "SUITE 302",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "07087",
            "telephone_number": "201-766-8222",
            "fax_number": "201-766-8221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY WELLNESS CENTER CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A",
        "authorized_official_last_name": "ESTRADA",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "201-766-8222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00695200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Union City, NJ
• Providers in Union City, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.