Prospero Medical Services New Jersey PC

Primary specialty

Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X

Legal business name

PROSPERO MEDICAL SERVICES NEW JERSEY PC

Practice address

1 Gateway Ctr Ste 2600
Newark, NJ 07102-5323

Phone

(866) 949-0108

NPI assigned

Dec 4, 2019

Last updated

Dec 27, 2021By 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

Mrs. Kimberly K Mann

Title

Credentialing Manager

Phone

(901) 422-7608

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1575417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640563200000",
    "number": "1043857436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 S B B KING BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032626",
            "telephone_number": "901-422-7644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GATEWAY CTR STE 2600",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071025323",
            "telephone_number": "866-949-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPERO MEDICAL SERVICES NEW JERSEY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-04",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "901-422-7608",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Hospice and Palliative Medicine (Family Medicine) Physician in Newark, NJ
• Providers in Newark, NJ by specialty
• Hospice and Palliative Medicine (Family Medicine) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; 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.