NPIMap

Organization Active NPI

Jewish Renaissance Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Newark, NJ
National Provider Identifier
1356769277
Registry record updated Mar 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
JEWISH RENAISSANCE MEDICAL CENTER, INC.
Practice address
258-380 Verona Avenue
Newark, NJ 07114
Phone
(973) 679-7709
Fax
(732) 324-5765
NPI assigned
Mar 29, 2014
Last updated
Mar 29, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2014

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

Authorized official

Name
Mark Roberts
Title
Ceo
Phone
(732) 376-9333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NJ Primary

Addresses

Primary practice location

258-380 Verona Avenue
Newark, NJ 07114

Mailing address

PO Box 1220
Perth Amboy, NJ 08862-1220
Phone (732) 376-9333

Other names 1

  • Park Elementary Other name

National Provider Directory

National Provider Directory
Tax ID family
Central Jersey Medical Center Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1396051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396051200000",
    "number": "1356769277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1220",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088621220",
            "telephone_number": "732-376-9333",
            "fax_number": "732-324-5765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258-380 VERONA AVENUE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07114",
            "telephone_number": "973-679-7709",
            "fax_number": "732-324-5765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEWISH RENAISSANCE MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-29",
        "last_updated": "2014-03-29",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "732-376-9333"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Elementary",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2014; 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.