Organization Active NPI

Nerdo Wellness LLC

  • Internal Medicine Physician
  • Laurel Springs, NJ
National Provider Identifier
1053252171
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NERDO WELLNESS LLC
Practice address
9 Tucker CT
Laurel Springs, NJ 08021-2813
Phone
(207) 649-0633
Fax
(856) 249-9599
NPI assigned
Apr 2, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Authorized official

Name
Dr. Nicholas Edward Roy, DONPI 1619288073
Title
Physician
Phone
(207) 649-0633

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

9 Tucker CT
Laurel Springs, NJ 08021-2813

Mailing address

111 Town Square PL Ste 1238
Jersey City, NJ 07310-1810
Phone (207) 649-0633

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1775088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775088000000",
    "number": "1053252171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 TOWN SQUARE PL STE 1238",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073101810",
            "telephone_number": "207-649-0633",
            "fax_number": "856-249-9599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 TUCKER CT",
            "city": "LAUREL SPRINGS",
            "state": "NJ",
            "postal_code": "080212813",
            "telephone_number": "207-649-0633",
            "fax_number": "856-249-9599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NERDO WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-02",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A",
        "authorized_official_last_name": "ROY",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "207-649-0633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel Springs, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2026; 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.