Jersey Shore Sports Medicine, LLC

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

25MB08601300 Issued in NJ

Legal business name

JERSEY SHORE SPORTS MEDICINE, LLC

Practice address

801 A Central Ave
Ocean City, NJ 08226

Phone

(609) 703-5097

NPI assigned

May 5, 2016

Last updated

May 5, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matt Legowski

Title

Operations

Phone

(609) 703-5097

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1462406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462406400000",
    "number": "1285080507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 A CENTRAL AVE",
            "city": "OCEAN CITY",
            "state": "NJ",
            "postal_code": "08226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 A CENTRAL AVE",
            "city": "OCEAN CITY",
            "state": "NJ",
            "postal_code": "08226",
            "telephone_number": "609-703-5097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY SHORE SPORTS MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-05",
        "last_updated": "2016-05-05",
        "status": "A",
        "authorized_official_last_name": "LEGOWSKI",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "OPERATIONS",
        "authorized_official_telephone_number": "609-703-5097"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NJ",
            "license": "25MB08601300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Hegel, OTR/L
• Nicolette Hensel, PT, DPT
• Cindy M Hernandez
• Diana L Holmes, COTA
• Horizon Eye Care PA
• Norma Theresa Juzwiak, B.S.R.PH.
• Christine H. Katsiff, R.PH,
• Stephen Katsiff, R.PH.
• Danielle Helene Kedziora, IBCLC
• Matthew P Kemenosh, D.C

• Non-Pharmacy Dispensing Site in Ocean City, NJ
• Providers in Ocean City, NJ by specialty
• Non-Pharmacy Dispensing Site in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; 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.