Organization Active NPI

John O'Connor, Psy.D., LLC.

  • Psychologist
  • New Egypt, NJ
National Provider Identifier
1073735502
Registry record updated Aug 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35SI00437800 Issued in NJ
Legal business name
JOHN O'CONNOR, PSY.D., LLC.
Practice address
54 Main St
New Egypt, NJ 08533-1413
Phone
(609) 758-1237
Fax
(609) 758-7255
NPI assigned
May 3, 2007
Last updated
Aug 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2008

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

Authorized official

Name
John James Oconnor, PSY.D.NPI 1285742668
Title
Member
Phone
(609) 758-1237

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
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 35SI00437800 NJ Primary

Addresses

Primary practice location

54 Main St
New Egypt, NJ 08533-1413

Mailing address

PO Box 236
New Egypt, NJ 08533-0236
Phone (609) 758-1237

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070601000377 NJ Part B Supplier - Clinic/Group Practice 0345348165 Receives reassigned benefits from 1 practitioner
Practice locations: Jackson, NJ

National Provider Directory

National Provider Directory

Locations

33 Main St
New Egypt, NJ 08533
Phone (609) 758-1237

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217808000000",
    "number": "1073735502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 236",
            "city": "NEW EGYPT",
            "state": "NJ",
            "postal_code": "085330236",
            "telephone_number": "609-758-1237",
            "fax_number": "609-758-7255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 MAIN ST",
            "city": "NEW EGYPT",
            "state": "NJ",
            "postal_code": "085331413",
            "telephone_number": "609-758-1237",
            "fax_number": "609-758-7255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN O'CONNOR, PSY.D., LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2008-08-04",
        "status": "A",
        "authorized_official_last_name": "OCONNOR",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "609-758-1237",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35SI00437800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Egypt, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.