Jersey Joint Spine & Regen, LLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

JERSEY JOINT SPINE & REGEN, LLC

Practice address

12 US Highway 9 Ste 108
Morganville, NJ 07751-1575

Phone

(732) 858-6638

Fax

(732) 858-6638

NPI assigned

Aug 28, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Gerald M Vernon, DONPI 1790851061

Title

Owner

Phone

(609) 643-0894

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gerald Michael Vernon, D.O.

  • Interventional Pain Medicine Physician
  • Morganville, NJ
  • NPI 1790851061
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714953600000",
    "number": "1295510352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 SANBORN AVE",
            "city": "POINT PLEASANT BEACH",
            "state": "NJ",
            "postal_code": "087422660",
            "telephone_number": "732-858-6638",
            "fax_number": "732-858-6638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 US HIGHWAY 9 STE 108",
            "city": "MORGANVILLE",
            "state": "NJ",
            "postal_code": "077511575",
            "telephone_number": "732-858-6638",
            "fax_number": "732-858-6638"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "144 Route 34",
            "address_purpose": "LOCATION",
            "city": "Matawan",
            "state": "NJ",
            "postal_code": "077472132",
            "country_code": "US",
            "telephone_number": "732-858-6638",
            "fax_number": "732-399-5463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JERSEY JOINT SPINE & REGEN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-28",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A",
        "authorized_official_last_name": "VERNON",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-643-0894",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Interventional Pain Medicine Physician in Morganville, NJ
• Providers in Morganville, NJ by specialty
• Interventional Pain Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.