Monmouth Medical Center Faculty Practice Plan, Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MONMOUTH MEDICAL CENTER FACULTY PRACTICE PLAN, INC.

Practice address

300 2ND Ave
Long Branch, NJ 07740-6303

Phone

(732) 571-0025

Fax

(732) 571-0400

NPI assigned

May 26, 2006

Last updated

Mar 9, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tanya Kenney

Title

Mmcfpp Manager

Phone

(732) 923-6281

Specialties & licenses 8

Addresses

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shira Goldberg, MD

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • West Orange, NJ
  • NPI 1710181607
  NPD (past)
• Luanne Petrie, R.D.

  • Registered Dietitian
  • Colts Neck, NJ
  • NPI 1013971878

  Single Specialty

  NPD (past)
• Kirby Douglas Rekedal, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Long Branch, NJ
  • NPI 1023197969
  NPD (past)
• Gweneth Wagnon, N.P.

  • Nurse Practitioner
  • Long Branch, NJ
  • NPI 1457497976
  NPD (past)
• Nicole Eckman, R.D., C.D.E.

  • Registered Dietitian
  • Westbrook, ME
  • NPI 1710933809
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331251200000",
    "number": "1023064441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8000",
            "address_2": "DEPT 601",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142670002",
            "telephone_number": "866-295-0041",
            "fax_number": "708-342-2517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 2ND AVE",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406303",
            "telephone_number": "732-571-0025",
            "fax_number": "732-571-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONMOUTH MEDICAL CENTER FACULTY PRACTICE PLAN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2012-03-09",
        "status": "A",
        "authorized_official_last_name": "KENNEY",
        "authorized_official_first_name": "TANYA",
        "authorized_official_title_or_position": "MMCFPP MANAGER",
        "authorized_official_telephone_number": "732-923-6281"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RA0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monmouth Medical Center
• Monmouth Medical Center
• Monmouth Medical Center
• Monmouth Medical Center
• Monmouth Medical Center
• Monmouth Medical Center Inc
• Monmouth Medical Center Inc
• Monmouth Medical Electrocardiology
• Monmouth Medical Imaging, PA
• Monmouth Neonatal Group, PA

• Internal Medicine Physician in Long Branch, NJ
• Providers in Long Branch, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2012; 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.