NPIMap

Organization Active NPI

New Jersey Anywhere Clinic LLC

  • Psychiatry Physician
  • Brick, NJ
National Provider Identifier
1114874336
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
NEW JERSEY ANYWHERE CLINIC LLC
Practice address
44 Princeton Ave Ste E
Brick, NJ 08724-3550
Phone
(702) 848-2256
Fax
(702) 485-6746
NPI assigned
Mar 16, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Authorized official

Name
Grant Bullock, DONPI 1174086391
Title
Owner
Phone
(702) 848-2256

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
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

44 Princeton Ave Ste E
Brick, NJ 08724-3550

Mailing address

4029 Dean Martin Dr
Las Vegas, NV 89103-4138

National Provider Directory

National Provider Directory

Locations

44 Princeton Ave
Ste E
Brick, NJ 08724

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": "1773619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773619200000",
    "number": "1114874336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4029 DEAN MARTIN DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891034138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 PRINCETON AVE STE E",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087243550",
            "telephone_number": "702-848-2256",
            "fax_number": "702-485-6746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW JERSEY ANYWHERE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-16",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A",
        "authorized_official_last_name": "BULLOCK",
        "authorized_official_first_name": "GRANT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-848-2256",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; 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.