Pain Relief Central New Jersey LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

26NJ00253100 Issued in NJ

Legal business name

PAIN RELIEF CENTRAL NEW JERSEY LLC

Practice address

1131 Broad St
201
Shrewsbury, NJ 07702-4329

Phone

(908) 692-9833

NPI assigned

Sep 14, 2015

Organization subpart

No

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

Authorized official

Name

Nicole Keegan, ANPNPI 1164752077

Title

Owner

Phone

(908) 692-9833

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Tax ID family

Pain Relief Center of Central New Jersey LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pain Relief Center of Central New Jersey, LLC

  • Pain Clinic/Center
  • Long Branch, NJ
  • NPI 1578944278
  NPD tax ID

Practitioners 1

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

• Nicole Keegan, NP

  • Family Nurse Practitioner
  • Long Branch, NJ
  • NPI 1164752077
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442188800000",
    "number": "1346618808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62",
            "address_2": "201",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077400062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 BROAD ST",
            "address_2": "201",
            "city": "SHREWSBURY",
            "state": "NJ",
            "postal_code": "077024329",
            "telephone_number": "908-692-9833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN RELIEF CENTRAL NEW JERSEY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-14",
        "last_updated": "2015-09-14",
        "status": "A",
        "authorized_official_last_name": "KEEGAN",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-692-9833",
        "authorized_official_credential": "ANP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00253100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenan Osmanovic, MD
• Chelsea Ostrom
• Vlady Ostrow, D.O.
• Ellem Oudmaijer de Rijk, CRNA
• Pace Physical Therapy LLC
• Janet M. Pair, PH.D., LMFT
• Amanda Rose Pallitto, MA, LAC, NCC
• Heather Pappas
• Steve John Paragioudakis, MD
• Casey Parks

• Nurse Practitioner in Shrewsbury, NJ
• Providers in Shrewsbury, NJ by specialty
• Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2015; 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.