Active NPI
Micheal O Nubi
- Physical Therapist
- Jackson, NJ
National Provider Identifier
1073702049
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- QA06692
- Practice address
- 4 Cedarview Ave
Jackson, NJ 08527-4887 - Phone
- (732) 500-7149
- NPI assigned
- Oct 16, 2007
- Last updated
- Oct 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | QA06692 | NJ | Primary |
Addresses
Primary practice location
4 Cedarview Ave
Jackson, NJ 08527-4887
Mailing address
4 Cedarview Ave
Jackson, NJ 08527-4887
Phone (732) 500-7149
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| QA06692 | NJ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192492800000",
"number": "1073702049",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 CEDARVIEW AVE",
"city": "JACKSON",
"state": "NJ",
"postal_code": "085274887",
"telephone_number": "732-500-7149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 CEDARVIEW AVE",
"city": "JACKSON",
"state": "NJ",
"postal_code": "085274887",
"telephone_number": "732-500-7149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUBI",
"first_name": "MICHEAL",
"middle_name": "O",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-10-16",
"last_updated": "2007-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "QA06692",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.