Mini Roy

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

26NJ00553600 Issued in NJ

Practice address

201 Lyons Ave
Newark, NJ 07112-2027

Phone

(973) 926-7754

NPI assigned

Feb 17, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1424131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424131200000",
    "number": "1235520925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BROOKSIDE PL",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070394034",
            "telephone_number": "908-810-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "973-926-7754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROY",
        "first_name": "MINI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-17",
        "last_updated": "2015-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00553600",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ00553600",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00553600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenya Danielle Roulhac
• Yvonne Rouse-Dixon
• Jennifer Rouse, RN
• Melissa Rovetto-Ruffner, LCSW
• Amit Kumar Roy, M.D.
• Monique S. Roy, M.D.
• Nikita Roy, MD, MPH
• Royal Ambulance, Inc
• Royal Apothecary LLC
• Royal Apothecary LLC

• Adult Health Nurse Practitioner in Newark, NJ
• Providers in Newark, NJ by specialty
• Adult Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.