Individual provider Active NPI

Carol Overtoom, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Bayville, NJ
National Provider Identifier
1407956022
Registry record updated Oct 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NJ00034000 Issued in NJ
Practice address
160 Route 9
Bayville, NJ 08721-1229
Phone
(732) 349-5550
NPI assigned
Sep 24, 2006
Last updated
Oct 8, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NJ00034000 NJ Primary
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist 364SP0807X NJ00034000 NJ

Addresses

Primary practice location

160 Route 9
Bayville, NJ 08721-1229

Mailing address

160 Route 9
Bayville, NJ 08721-1229
Phone (732) 349-5550

Other identifiers 1

IdentifierTypeStateIssuer
4144007MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NJ00034000NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities, Diocese of Trenton CurrentSince Nov 8, 2016 Accepting new patients

Locations

383 W State St
Trenton, NJ 08618
Phone (609) 394-5181

39 N Clinton Ave
Trenton, NJ 08609
Phone (609) 394-5157

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349654400000",
    "number": "1407956022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 ROUTE 9",
            "city": "BAYVILLE",
            "state": "NJ",
            "postal_code": "087211229",
            "telephone_number": "732-349-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 ROUTE 9",
            "city": "BAYVILLE",
            "state": "NJ",
            "postal_code": "087211229",
            "telephone_number": "732-349-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERTOOM",
        "first_name": "CAROL",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-24",
        "last_updated": "2012-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "NJ00034000",
            "primary": true
        },
        {
            "code": "364SP0807X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Adolescent",
            "state": "NJ",
            "license": "NJ00034000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4144007",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayville, NJ

Sources for this page

Verify at the official NPI Registry.