Montclair State University Occupational Health

Primary specialty

Occupational Medicine Clinic/CenterTaxonomy code 261QX0100X

Legal business name

MONTCLAIR STATE UNIVERSITY OCCUPATIONAL HEALTH

Practice address

1 Normal Avenue
Blanton Hall
Montclair, NJ 07043-1624

Phone

(973) 655-5014

NPI assigned

Nov 3, 2020

Last updated

Nov 3, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

MONTCLAIR STATE UNIVERSITYAs reported in NPPES

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

Authorized official

Name

Dr. Gregg Summerville, MDNPI 1982604922

Title

Occupational Health Physician

Phone

(973) 655-5014

Specialties & licenses 1

Addresses

Part of

Montclair State University Occupational Health

Practitioners 1

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.

• Gregg Summerville, M.D.

  • Emergency Medicine Physician
  • Paterson, NJ
  • NPI 1982604922
  NPD Authorized official

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604361600000",
    "number": "1376144790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 NORMAL AVENUE",
            "address_2": "BLANTON HALL",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070431624",
            "telephone_number": "973-655-5014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 NORMAL AVENUE",
            "address_2": "BLANTON HALL",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070431624",
            "telephone_number": "973-655-5014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTCLAIR STATE UNIVERSITY OCCUPATIONAL HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MONTCLAIR STATE UNIVERSITY",
        "enumeration_date": "2020-11-03",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A",
        "authorized_official_last_name": "SUMMERVILLE",
        "authorized_official_first_name": "GREGG",
        "authorized_official_title_or_position": "OCCUPATIONAL HEALTH PHYSICIAN",
        "authorized_official_telephone_number": "973-655-5014",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Montclair Rehab Services, LLC
• Montclair Spine & Sports Rehab, LLC
• Montclair State University (Center for Autism and Early Childhood Mental Health)
• Montclair State University (Montclair State Clinical Services Group)
• Montclair State University Health Center
• Montclair Surgical Services LLC
• Montclair Therapy Associates LLC
• Montclair Upper Cervical Chiropractic, LLC
• Montclair Vision Services
• Pauline Montemayor, LCSW

• Occupational Medicine Clinic/Center in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Occupational Medicine Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; 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.