NPIMap

Organization Active NPI

YMCA of Greater Monmouth County

  • Community/Behavioral Health Agency
  • Hazlet, NJ
National Provider Identifier
1063958148
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
100002804 Issued in NJ
Legal business name
YMCA OF GREATER MONMOUTH COUNTY
Practice address
419 Middle Rd
Hazlet, NJ 07730-2428
Phone
(732) 290-9040
Fax
(732) 566-0433
NPI assigned
Jan 12, 2017
Last updated
Aug 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Authorized official

Name
Leeann Wagner
Title
Vice President
Phone
(732) 290-9040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 100002804 NJ Primary

Addresses

Primary practice location

419 Middle Rd
Hazlet, NJ 07730-2428

Mailing address

166 Main St
Matawan, NJ 07747-3104
Phone (732) 290-9040

Other identifiers 1

IdentifierTypeStateIssuer
0556459MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
YMCA of the Jersey Shore129 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

Locations

419 Middle Rd
Hazlet, NJ 07730
Phone (732) 264-8411

NPI Registry JSON

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597104000000",
    "number": "1063958148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 MAIN ST",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077473104",
            "telephone_number": "732-290-9040",
            "fax_number": "732-566-0433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 MIDDLE RD",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077302428",
            "telephone_number": "732-290-9040",
            "fax_number": "732-566-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YMCA OF GREATER MONMOUTH COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-12",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "LEEANN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "732-290-9040"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NJ",
            "license": "100002804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0556459",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazlet, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; 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.