Individual provider Active NPI

Joshua Menard

  • Psychiatric/Mental Health Registered Nurse
  • Newark, DE
National Provider Identifier
1215368410
Registry record updated Dec 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
L1-0039335 Issued in DE
Practice address
100 Rockford Dr
Newark, DE 19713-2120
Phone
(302) 996-5480
NPI assigned
Dec 12, 2013
Last updated
Dec 12, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X L1-0039335 DE Primary

Addresses

Primary practice location

100 Rockford Dr
Newark, DE 19713-2120

Mailing address

1903 Iris CT
Phoenixville, PA 19460-4843
Phone (302) 753-9055

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

LicenseStateTypeSpecialty
L1-0039335DEMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386806400000",
    "number": "1215368410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 IRIS CT",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "194604843",
            "telephone_number": "302-753-9055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ROCKFORD DR",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132120",
            "telephone_number": "302-996-5480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENARD",
        "first_name": "JOSHUA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-12",
        "last_updated": "2013-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "DE",
            "license": "L1-0039335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2013; 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.