NPIMap

Organization Active NPI

Ez Mind Family Mental Health LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lanoka Harbor, NJ
National Provider Identifier
1093448599
Registry record updated Jul 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
EZ MIND FAMILY MENTAL HEALTH LLC
Practice address
500 Main St
Lanoka Harbor, NJ 08734-2228
Phone
(609) 916-6443
Fax
(732) 358-0829
NPI assigned
Jul 3, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2022

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

Authorized official

Name
Jan Ford, APNNPI 1912564428
Title
Pmhnp/FNP
Phone
(609) 916-6443

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

500 Main St
Lanoka Harbor, NJ 08734-2228

Mailing address

500 Main St
Lanoka Harbor, NJ 08734-2228
Phone (609) 916-6443

Other identifiers 2

IdentifierTypeStateIssuer
1912564428MedicaidNJ
1912564428OtherNJCOMMERCIAL INSURANCE

Electronic endpoints 3

TypeEndpointUseAffiliation
CONNECT URL www.ezmindfamilymentalheatlh.com Health Information Exchange (HIE)
CONNECT URL www.ezmindfamilymentalheatlh.com Health Information Exchange (HIE)
CONNECT URL ezmindfamilymentalhealth.com Direct

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": "1656806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656806400000",
    "number": "1093448599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MAIN ST",
            "city": "LANOKA HARBOR",
            "state": "NJ",
            "postal_code": "087342228",
            "telephone_number": "609-916-6443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MAIN ST",
            "city": "LANOKA HARBOR",
            "state": "NJ",
            "postal_code": "087342228",
            "telephone_number": "609-916-6443",
            "fax_number": "732-358-0829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EZ MIND FAMILY MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-03",
        "last_updated": "2022-07-03",
        "certification_date": "2022-07-03",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "JAN",
        "authorized_official_title_or_position": "PMHNP/FNP",
        "authorized_official_telephone_number": "609-916-6443",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912564428",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL INSURANCE",
            "identifier": "1912564428",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.ezmindfamilymentalheatlh.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "500 Main St",
            "city": "Lanoka Harbor",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "087342228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.ezmindfamilymentalheatlh.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "500 Main St",
            "city": "Lanoka Harbor",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "087342228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ezmindfamilymentalhealth.com",
            "affiliation": "N",
            "endpointDescription": "HPI",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "500 Main St",
            "city": "Lanoka Harbor",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "087342228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lanoka Harbor, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2022; 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.