Organization Active NPI

Oakland Integrated Care Network LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Williamstown, NJ
National Provider Identifier
1003546201
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
OAKLAND INTEGRATED CARE NETWORK LLC
Practice address
713 Welsh LN
Williamstown, NJ 08094-6303
Phone
(856) 553-2755
NPI assigned
Jun 13, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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

Authorized official

Name
Michael Ajayi, MDNPI 1801124599
Title
Owner
Phone
(856) 553-2755

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
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

713 Welsh LN
Williamstown, NJ 08094-6303

Mailing address

713 Welsh LN
Williamstown, NJ 08094-6303
Phone (856) 553-2755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230309000375 NJ Part B Supplier - Clinic/Group Practice 8022481290 Receives reassigned benefits from 1 practitioner
Practice locations: Vineland, NJ

National Provider Directory

National Provider Directory

Locations

521 Sicklerville Rd
Ste 3C
Sicklerville, NJ 08081
Phone (856) 553-8724

1317 S Main Rd
Vineland, NJ 08360
Phone (609) 691-2248

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655078400000",
    "number": "1003546201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 WELSH LN",
            "city": "WILLIAMSTOWN",
            "state": "NJ",
            "postal_code": "080946303",
            "telephone_number": "856-553-2755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 WELSH LN",
            "city": "WILLIAMSTOWN",
            "state": "NJ",
            "postal_code": "080946303",
            "telephone_number": "856-553-2755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKLAND INTEGRATED CARE NETWORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-06",
        "status": "A",
        "authorized_official_last_name": "AJAYI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-553-2755",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamstown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.