SPINE & SPORTS MEDICINE OF TINTON FALLS LLC (NPI# 1801315635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801315635 |
| Entity Type | Organization |
| Organization Name | SPINE & SPORTS MEDICINE OF TINTON FALLS LLC |
| Practice Address |
4057 Asbury Ave Ste 4 Tinton Falls NJ 07753-7700 |
| Mailing Address |
4057 Asbury Ave Store #4 Tinton Falls NJ 07753-7700 |
| Practice Telephone | 7323333099 |
| Mailing Telephone | 7323333099 |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2018-03-19 |
| Authorized Official Name | NICOLE FULLAWAY (OWNER) |
| Authorized Official Telephone | 6095059090 |
| Authorized Official Credential | DPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 171100000X | Acupuncturist | Other Service Providers | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
| N | 111N00000X | Chiropractor | Chiropractic Providers | ||
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
4057 ASBURY AVE STE 4 |
| City | TINTON FALLS |
| State | NJ |
| Zip Code | 07753-7700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427558212 | Melissa Mcconnell | Acupuncturist | 4057 Asbury Ave Ste 4, Tinton Falls, NJ 07753-7700 | 2018-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255938361 | Maryjoy Marzan | Nurse Practitioner | Hope Tower - Jersey Shore University Medical Center, 19 Davis St 6th Floor, Neptune, NJ 07753 | 2020-10-02 |
| 1174138952 | Darlene Lupo | Nurse Practitioner | 72 Morris Ave, Neptune, NJ 07753 | 2020-09-09 |
| 1124645148 | Charlotte Emily Parker | Audiologist | 3700 Nj-33, Suite 101, Neptune City, NJ 07753 | 2020-06-26 |
| 1023667896 | Joseph Renninger | Psychologist | 2100 Route 33 Suite 9/10, Neptune, NJ 07753 | 2019-09-05 |
| 1952950800 | Matthew Aaron Brigle | Psychologist | 2100 Nj-33, Suite 9-10, Neptune City, NJ 07753 | 2019-09-04 |
| 1285292110 | Joseph F Mcnamara | Nurse Practitioner | 1945 Nj State Highway 33, Neptune, NJ 07753 | 2019-06-05 |
| 1679046601 | Richard Valderas Penalosa Jr. | Nurse Practitioner | 409 Locust St, Neptune, NJ 07753 | 2019-01-02 |
| 1528539822 | Neptune Rx LLC | Pharmacy | West Lake Pharmacy, 1828 West Lake Avenue, Neptune, NJ 07753 | 2018-12-12 |
| 1053880286 | Hmh Hospitals Corporation | Clinic/Center | 1200 Jumping Brook Rd., Bldg 5, Ste 201, Neptune, NJ 07753 | 2018-11-16 |
| 1972084424 | Melissa Hillebrecht | Psychologist | 2100 Nj-33 Suite 9-10, Neptune, NJ 07753 | 2018-08-23 |
| Find all providers in zip 07753 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841802220 | Spine & Pain Institute of New Jersey | Pain Medicine | 757 Route 202-206, Suite 104, Bridgewater, NJ 08807-0880 | 2020-08-18 |
| 1225680796 | Nj Interventional Pain Management LLC | Pain Medicine | 560 Hudson St Ste 301, Hackensack, NJ 07601-6655 | 2019-07-15 |
| 1780246017 | Premier Pain Centers, LLC | Pain Medicine | 1430 Hooper Ave Ste 205, Toms River, NJ 08753-2895 | 2019-07-08 |
| 1083271134 | Us Functional, LLC | Pain Medicine | 813 E Gate Dr Ste C, Mount Laurel, NJ 08054-1238 | 2019-05-23 |
| 1770043515 | Healthcare Pain Centers LLC | Pain Medicine | 362 Us Highway 9 Unit 203, Englishtown, NJ 07726-9224 | 2019-03-20 |
| 1780165829 | Premier Pain Centers, LLC. | Pain Medicine | 561 Cranbury Rd Ste 1, East Brunswick, NJ 08816-5400 | 2018-08-27 |
| 1063993103 | Premier Pain Centers, LLC. | Pain Medicine | 150 Chambers Bridge Rd Ste 201, Brick, NJ 08723-3491 | 2018-08-27 |
| 1720592942 | Pain Associates of Bergen County LLC | Pain Medicine | 294 State Street, Suite 2, Hackensack, NJ 07601 | 2017-11-27 |
| 1811421696 | Precision Spine & Sports Medicine Inc | Pain Medicine | 1346 How Ln Ste 107, North Brunswick, NJ 08902-1728 | 2017-04-18 |
| 1063879971 | Central Pain and Wellness | Pain Medicine | 725 Mill St, Moorestown, NJ 08057-1803 | 2016-01-22 |
| Find all providers with the same taxonomy | ||||
| City | TINTON FALLS |
| Zip Code | 07753 |
Please comment or provide details below to improve the information on SPINE & SPORTS MEDICINE OF TINTON FALLS LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.