Active NPI
Zachary Dymond-Drake
- Social Worker
- Elizabeth, NJ
National Provider Identifier
1144954082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 44SL05747200
- Practice address
- 655 E Jersey St
Elizabeth, NJ 07206-1259 - Phone
- (908) 994-7620
- NPI assigned
- Jul 15, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 44SL05747200 | NJ | Primary |
Addresses
Primary practice location
655 E Jersey St
Elizabeth, NJ 07206-1259
Mailing address
151 Centennial Ave
Piscataway, NJ 08854-3907
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | zackyd@ubhc.rutgers.edu |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SL05747200 | NJ | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657843200000",
"number": "1144954082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151 CENTENNIAL AVE",
"city": "PISCATAWAY",
"state": "NJ",
"postal_code": "088543907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "655 E JERSEY ST",
"city": "ELIZABETH",
"state": "NJ",
"postal_code": "072061259",
"telephone_number": "908-994-7620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYMOND-DRAKE",
"first_name": "ZACHARY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-15",
"last_updated": "2022-07-15",
"certification_date": "2022-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NJ",
"license": "44SL05747200",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "zackyd@ubhc.rutgers.edu",
"affiliation": "N",
"address_1": "655 E Jersey St",
"city": "Elizabeth",
"state": "NJ",
"country_code": "US",
"postal_code": "072061259",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Elizabeth, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.