Active NPI
Raquel Anna Ortiz, BA
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Hainesport, NJ
National Provider Identifier
1013527738
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Practice address
- 506 2ND St
Hainesport, NJ 08036-2608 - Phone
- (609) 314-5237
- NPI assigned
- Aug 6, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | Primary |
Addresses
Primary practice location
506 2ND St
Hainesport, NJ 08036-2608
Mailing address
506 2ND St
Hainesport, NJ 08036-2608
Phone (609) 314-5237
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596672000000",
"number": "1013527738",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "506 2ND ST",
"city": "HAINESPORT",
"state": "NJ",
"postal_code": "080362608",
"telephone_number": "609-314-5237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "506 2ND ST",
"city": "HAINESPORT",
"state": "NJ",
"postal_code": "080362608",
"telephone_number": "609-314-5237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTIZ",
"first_name": "RAQUEL",
"middle_name": "ANNA",
"credential": "BA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-06",
"last_updated": "2020-08-06",
"certification_date": "2020-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hainesport, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.