Organization Active NPI

Dominion Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Green Brook, NJ
National Provider Identifier
1235757485
Registry record updated Oct 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
DOMINION HEALTH
Practice address
933 N Washington Ave Ste 2C
Green Brook, NJ 08812-2600
Phone
(469) 257-3500
NPI assigned
Jul 13, 2020
Last updated
Oct 26, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2026

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

Authorized official

Name
Mr. Adebayo Arowolo, NPNPI 1508405382
Title
Ceo
Phone
(469) 257-3500

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
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

933 N Washington Ave Ste 2C
Green Brook, NJ 08812-2600

Mailing address

245 Bayville Ave
Bayville, NJ 08721-1050
Phone (469) 257-3500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200729000923 NJ Part B Supplier - Clinic/Group Practice 0244655983 Receives reassigned benefits from 4 practitioners
Practice locations: Green Brook, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792972800000",
    "number": "1235757485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 BAYVILLE AVE",
            "city": "BAYVILLE",
            "state": "NJ",
            "postal_code": "087211050",
            "telephone_number": "469-257-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 N WASHINGTON AVE STE 2C",
            "city": "GREEN BROOK",
            "state": "NJ",
            "postal_code": "088122600",
            "telephone_number": "469-257-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMINION HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-13",
        "last_updated": "2026-10-26",
        "certification_date": "2026-10-26",
        "status": "A",
        "authorized_official_last_name": "AROWOLO",
        "authorized_official_first_name": "ADEBAYO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "469-257-3500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Brook, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.