NPIMap

Organization Active NPI

Family Mental Health Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Union, NJ
National Provider Identifier
1285289884
Registry record updated Aug 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
FAMILY MENTAL HEALTH SERVICES LLC
Doing business as
Family Mental Health Services LL C
Practice address
540 North Ave Ste 4
Union, NJ 07083-7149
Phone
(908) 588-2445
Fax
(908) 558-0170
NPI assigned
Aug 9, 2019
Last updated
Aug 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2024

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

Authorized official

Name
Patrick Obinna OledimmahNPI 1518477504
Title
Apn
Phone
(862) 368-5801

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: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

540 North Ave Ste 4
Union, NJ 07083-7149

Mailing address

540 North Ave Ste 4
Union, NJ 07083-7149
Phone (908) 588-2445

Other names 1

  • Family Mental Health Services LL C Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190930001731 NJ Part B Supplier - Clinic/Group Practice 0547590812 Receives reassigned benefits from 1 practitioner
Practice locations: Union, NJ

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1565308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724457600000",
    "number": "1285289884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 NORTH AVE STE 4",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070837149",
            "telephone_number": "908-588-2445",
            "fax_number": "908-558-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 NORTH AVE STE 4",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070837149",
            "telephone_number": "908-588-2445",
            "fax_number": "908-558-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MENTAL HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-09",
        "last_updated": "2024-08-24",
        "certification_date": "2024-08-24",
        "status": "A",
        "authorized_official_last_name": "OLEDIMMAH",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "OBINNA",
        "authorized_official_title_or_position": "APN",
        "authorized_official_telephone_number": "862-368-5801"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Mental Health Services LL C",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Mental Health Services LL C",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Union, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2024; 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.