Jersey Shore Convalescent Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

061317 Issued in NJ

Legal business name

JERSEY SHORE CONVALESCENT CENTER

Practice address

2050 Sixth Ave
Neptune City, NJ 07753-6124

Phone

(732) 774-8300

Fax

(732) 774-0908

NPI assigned

Sep 23, 2005

Organization subpart

No

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

Authorized official

Name

Mary Lou Browning, LNHA

Title

Administrator

Phone

(732) 774-8300

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Medicenter/Neptune City Doing business as

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275523200000",
    "number": "1013903103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 6TH AVE",
            "city": "NEPTUNE CITY",
            "state": "NJ",
            "postal_code": "077536124",
            "telephone_number": "732-774-8300",
            "fax_number": "732-774-0908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 SIXTH AVE",
            "city": "NEPTUNE CITY",
            "state": "NJ",
            "postal_code": "077536124",
            "telephone_number": "732-774-8300",
            "fax_number": "732-774-0908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY SHORE CONVALESCENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-23",
        "last_updated": "2010-06-03",
        "status": "A",
        "authorized_official_last_name": "BROWNING",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "LOU",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "732-774-8300",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NJ",
            "license": "061317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4488407",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicenter/Neptune City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Philip A Hickey IV, MSW/LCSW
• HMH Hospitals Corporation
• In Tune Collective, LLC
• Kristine Victoria Infante, LCSW
• Alexis Jagger, PA-C
• Jersey Shore Medical Center
• Jersey Shore Post Acute Rehabilitation and Nursing LLC
• Jessica Anne Jirak, MSN, FNP-BC
• Marcus Joseph
• Yaseen I Kadura, MD

• Skilled Nursing Facility in Neptune City, NJ
• Providers in Neptune City, NJ by specialty
• Skilled Nursing Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.