Organization Active NPI

Marcy Roshelli

  • Psychiatric/Mental Health Nurse Practitioner
  • Manahawkin, NJ
National Provider Identifier
1518152453
Registry record updated Sep 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NN05675900 Issued in NJ
Legal business name
MARCY ROSHELLI
Practice address
1301 Route 72 W
Suite 250
Manahawkin, NJ 08050-2483
Phone
(609) 312-9269
Fax
(609) 207-4102
NPI assigned
Sep 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2007

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

Authorized official

Name
Marcella Roshelli, APRN-BC
Title
Owner
Phone
(609) 312-9269

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 26NN05675900 NJ Primary

Addresses

Primary practice location

1301 Route 72 W
Suite 250
Manahawkin, NJ 08050-2483

Mailing address

18 N 7TH St
Surf City, NJ 08008-5201
Phone (609) 312-9269

Other identifiers 1

IdentifierTypeStateIssuer
8092605MedicaidNJ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189641600000",
    "number": "1518152453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 N 7TH ST",
            "city": "SURF CITY",
            "state": "NJ",
            "postal_code": "080085201",
            "telephone_number": "609-312-9269",
            "fax_number": "609-207-4102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 ROUTE 72 W",
            "address_2": "SUITE 250",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080502483",
            "telephone_number": "609-312-9269",
            "fax_number": "609-207-4102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARCY ROSHELLI",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-13",
        "last_updated": "2007-09-13",
        "status": "A",
        "authorized_official_last_name": "ROSHELLI",
        "authorized_official_first_name": "MARCELLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-312-9269",
        "authorized_official_credential": "APRN-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NN05675900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8092605",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manahawkin, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2007; 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.