NPIMap

Organization Active NPI

Visiting Nurse Association of Central Jersey Community Health Center I

  • Federally Qualified Health Center (FQHC)
  • Keansburg, NJ
National Provider Identifier
1104964550
Registry record updated Dec 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
VISITING NURSE ASSOCIATION OF CENTRAL JERSEY COMMUNITY HEALTH CENTER I
Practice address
100 Main Street
Keansburg, NJ 07734
Phone
(732) 787-1250
Fax
(732) 787-4079
NPI assigned
Feb 1, 2007
Last updated
Dec 4, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2017

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

Authorized official

Name
Mr. Gary S Linington
Title
Executive Director
Phone
(732) 502-5151

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X
Federally Qualified Health Center (FQHC) 261QF0400X NJ Primary

Addresses

Primary practice location

100 Main Street
Keansburg, NJ 07734

Mailing address

1301 Main Street
Asbury Park, NJ 07712
Phone (732) 774-6333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040107000585 NJ Part B Supplier - Clinic/Group Practice 1456250679 Receives reassigned benefits from 91 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Asbury Park, NJ; Freehold, NJ; Keyport, NJ; Red Bank, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104964550. Details of each certification follow.

  • CCN 311876 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 311876

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
KEANSBURG COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 9, 2007
Last certification
Oct 9, 2007
Ownership / control type
For profit – corporation
Facility address
100 Main Street
Keansburg, NJ 07734

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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, 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": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512345600000",
    "number": "1104964550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 MAIN STREET",
            "city": "ASBURY PARK",
            "state": "NJ",
            "postal_code": "07712",
            "telephone_number": "732-774-6333",
            "fax_number": "732-774-0313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MAIN STREET",
            "city": "KEANSBURG",
            "state": "NJ",
            "postal_code": "07734",
            "telephone_number": "732-787-1250",
            "fax_number": "732-787-4079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISITING NURSE ASSOCIATION OF CENTRAL JERSEY COMMUNITY HEALTH CENTER I",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2017-12-04",
        "status": "A",
        "authorized_official_last_name": "LININGTON",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "732-502-5151",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keansburg, NJ

Sources for this page

Verify at the official NPI Registry.