NPIMap

Organization Active NPI

St Remi LLC

  • Psychiatry Physician
  • Gloucester City, NJ
National Provider Identifier
1144583519
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
ST REMI LLC
Practice address
822 Klemm Ave
Gloucester City, NJ 08030-1627
Phone
(856) 282-5566
Fax
(856) 396-9917
NPI assigned
Jun 20, 2012
Last updated
Feb 4, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
LBNAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Authorized official

Name
Isiaka A BolarinwaNPI 1467403196
Title
President/ Medical Director
Phone
(856) 282-5566

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary
Child & Adolescent Psychiatry Physician 2084P0804X NU
Psychiatric/Mental Health Nurse Practitioner 363LP0808X MA072697 NJ

Addresses

Primary practice location

822 Klemm Ave
Gloucester City, NJ 08030-1627

Mailing address

822 Klemm Ave
Gloucester City, NJ 08030-1627
Phone (856) 282-5566

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130426000191 NJ Part B Supplier - Clinic/Group Practice 0042456683 Receives reassigned benefits from 10 practitioners
Practice locations: Gloucester City, NJ

National Provider Directory

National Provider Directory
Tax ID family
St Remi LLC2 organizations share this tax ID, including this one
Part of
St Remi LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770163200000",
    "number": "1144583519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 KLEMM AVE",
            "city": "GLOUCESTER CITY",
            "state": "NJ",
            "postal_code": "080301627",
            "telephone_number": "856-282-5566",
            "fax_number": "856-885-4471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 KLEMM AVE",
            "city": "GLOUCESTER CITY",
            "state": "NJ",
            "postal_code": "080301627",
            "telephone_number": "856-282-5566",
            "fax_number": "856-396-9917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST REMI LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LBN",
        "enumeration_date": "2012-06-20",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A",
        "authorized_official_last_name": "BOLARINWA",
        "authorized_official_first_name": "ISIAKA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/ MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "856-282-5566"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "MA072697",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloucester City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; 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.