J Calvin Chatlos MD LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MA 46262 Issued in NJ

Legal business name

J CALVIN CHATLOS MD LLC

Practice address

400 W Main St
Freehold, NJ 07728-2529

Phone

(732) 414-6001

Fax

(732) 677-3149

NPI assigned

Oct 16, 2009

Organization subpart

No

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

Authorized official

Name

Dr. John Calvin Chatlos Jr., MD

Title

Sole Proprietor

Phone

(732) 414-6001

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• JOHN C CHATLOS MD Doing business as

Locations

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

{
    "created_epoch": "1255651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255651200000",
    "number": "1417282922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W MAIN ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282529",
            "telephone_number": "732-414-6001",
            "fax_number": "732-677-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W MAIN ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282529",
            "telephone_number": "732-414-6001",
            "fax_number": "732-677-3149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J CALVIN CHATLOS MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-16",
        "last_updated": "2009-10-16",
        "status": "A",
        "authorized_official_last_name": "CHATLOS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "CALVIN",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "732-414-6001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NJ",
            "license": "MA 46262",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "MA 46262",
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "NJ",
            "license": "MA 46262",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NJ",
            "license": "MA 46262",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2508206",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JOHN C CHATLOS MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Joanne Iwama, LSW
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• Jackson Family Practice LLC
• Alina Jackson, DPT
• Jennell A Jackson, LCSW
• Jessica A Jacob
• Syed Ali Jaffari, HIS

• Psychiatry Physician in Freehold, NJ
• Providers in Freehold, NJ by specialty
• Psychiatry Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2009; 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.