Active NPI
Jill I Sharon, D.O.
- Pediatrics Physician
- Lakewood, NJ
National Provider Identifier
1033115530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 25MB07828500
- Practice address
- 1771 Madison Ave
Center for Health Education, Medicine and Dentistry
Lakewood, NJ 08701-1251 - Phone
- (732) 364-2144
- Fax
- (732) 364-3559
- NPI assigned
- Jun 21, 2005
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 25MB07828500 | NJ | Primary |
Addresses
Primary practice location
1771 Madison Ave
Center for Health Education, Medicine and Dentistry
Lakewood, NJ 08701-1251
Mailing address
1771 Madison Ave
Center for Health Education, Medicine and Dentistry
Lakewood, NJ 08701-1251
Phone (732) 364-2144
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0155284 | Medicaid | NJ |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MB07828500 | NJ | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225324800000",
"number": "1033115530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1771 MADISON AVE",
"address_2": "CENTER FOR HEALTH EDUCATION, MEDICINE AND DENTISTRY",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087011251",
"telephone_number": "732-364-2144",
"fax_number": "732-364-3559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1771 MADISON AVE",
"address_2": "CENTER FOR HEALTH EDUCATION, MEDICINE AND DENTISTRY",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087011251",
"telephone_number": "732-364-2144",
"fax_number": "732-364-3559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHARON",
"first_name": "JILL",
"middle_name": "I",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-21",
"last_updated": "2008-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "25MB07828500",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0155284",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.