Individual provider Active NPI

Alice Lemmy Kalu, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Manalapan, NJ
National Provider Identifier
1245870658
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ01006700 Issued in NJ
Practice address
500 Park Ave
Manalapan, NJ 07726-8375
Phone
(732) 679-4500
NPI assigned
Jan 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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 Nurse Practitioner 363LP0808X 26NJ01006700 NJ Primary

Addresses

Primary practice location

500 Park Ave
Manalapan, NJ 07726-8375

Mailing address

500 Park Ave
Manalapan, NJ 07726-8375
Phone (732) 679-4500

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200213002663 NJ Practitioner - Nurse Practitioner 3870929698 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Diamond Valley Behavioral LLCGroup PAC ID 2466831615, 3 clinicians

Practice addresses (Care Compare)

427 High St
Unit 1823
Burlington, NJ 08016-4585

563 High St
Suite B
Burlington, NJ 08016-4592
Phone (609) 496-0285

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ01006700NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stable Community Services CurrentSince Nov 1, 2020 Accepting new patients
Diamond Valley Behavioral LLC Psychiatric/Mental Health CurrentSince Jul 30, 2022 Accepting new patients
CPC Behavioral Healthcare, Inc CurrentSince Jun 7, 2021 Accepting new patients
Mind Your Mind CurrentSince Apr 15, 2021 Accepting new patients
Stress Care of New Jersey, LLC CurrentSince Jan 22, 2020 Accepting new patients
Diamond Valley Behavioral Health LLC Psychiatric/Mental Health CurrentSince Aug 14, 2022 Accepting new patients
CPC Integrated Health, Inc. CurrentSince Jun 7, 2021 Accepting new patients
Stress Care of New Jersey, LLC CurrentSince Jan 22, 2020 Accepting new patients
Stable Community Services Past Accepting new patients

Locations

563 High St
Ste B
Burlington, NJ 08016
Phone (609) 496-0285

427 High St
Unit 1823
Burlington City, NJ 08016
Phone (609) 496-0285

513 High St
Burlington City, NJ 08016
Phone (609) 386-0650

10 Industrial Way E
Eatontown, NJ 07724
Phone (732) 935-2220

22 Court St
Freehold, NJ 07728
Phone (732) 780-7387

4539 US Highway 9
Howell, NJ 07731
Phone (732) 901-5553

500 Park Ave
Manalapan, NJ 07726
Phone (732) 679-4500

4122 Route 516
Matawan, NJ 07747
Phone (732) 679-4500

2083 Klockner Rd
Trenton, NJ 08690
Phone (609) 222-4902

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1245870658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 PARK AVE",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077268375",
            "telephone_number": "732-679-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PARK AVE",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077268375",
            "telephone_number": "732-679-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALU",
        "first_name": "ALICE",
        "middle_name": "LEMMY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-14",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01006700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manalapan, NJ

Sources for this page

Verify at the official NPI Registry.