Individual provider Active NPI

Jasmine Norris

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Summit, NJ
National Provider Identifier
1053846626
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
N66513887558882 Issued in NJ
Practice address
48 Russell PL
Summit, NJ 07901-3814
Phone
(908) 848-7116
NPI assigned
Apr 20, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X N666513887558882 NJ
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X N66513887558882 NJ Primary

Addresses

Primary practice location

48 Russell PL
Summit, NJ 07901-3814

Mailing address

48 Russell PL
Summit, NJ 07901-3814
Phone (908) 848-7116

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
N666513887558882NJMDCase Manager/Care Coordinator
N66513887558882NJMDIntellectual and/or Developmental Disabilities Residential Treatment Facility

NPI Registry JSON

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

{
    "created_epoch": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1053846626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 RUSSELL PL",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013814",
            "telephone_number": "908-848-7116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 RUSSELL PL",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013814",
            "telephone_number": "908-848-7116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORRIS",
        "first_name": "JASMINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-20",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NJ",
            "license": "N666513887558882",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NJ",
            "license": "N66513887558882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; 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.