Organization Active NPI

Weequahic Park Sports Authority

  • Non-emergency Medical Transport (VAN)
  • Newark, NJ
National Provider Identifier
1417808411
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Legal business name
WEEQUAHIC PARK SPORTS AUTHORITY
Practice address
92 Thomas Carmichael Drive
Newark, NJ 07114
Phone
(973) 877-9772
Fax
(973) 877-9772
NPI assigned
Feb 5, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2026

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

Authorized official

Name
Douglas Freeman
Title
President
Phone
(973) 877-9772

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Home Delivered Meals 332U00000X
Non-emergency Medical Transport (VAN) 343900000X Primary

Addresses

Primary practice location

92 Thomas Carmichael Drive
Newark, NJ 07114

Mailing address

PO Box 4252
Newark, NJ 07112-0252
Phone (973) 877-9772

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1770249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770249600000",
    "number": "1417808411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4252",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071120252",
            "telephone_number": "973-877-9772",
            "fax_number": "973-877-9772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 THOMAS CARMICHAEL DRIVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07114",
            "telephone_number": "973-877-9772",
            "fax_number": "973-877-9772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEEQUAHIC PARK SPORTS AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-05",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-02",
        "status": "A",
        "authorized_official_last_name": "FREEMAN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-877-9772"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 5, 2026; 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.