Organization Active NPI

Pjo Health Services LLC

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Mount Laurel, NJ
National Provider Identifier
1548880941
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X
Legal business name
PJO HEALTH SERVICES LLC
Practice address
1200 S Church St Ste 3
Mount Laurel, NJ 08054-2936
Phone
(856) 359-4799
Fax
(856) 249-9068
NPI assigned
Apr 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Authorized official

Name
Julietteosborne Osborne, FNP
Title
Ceo
Phone
(856) 356-4799

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Addiction Medicine (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084A0401X Primary
Addiction Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0802X
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

1200 S Church St Ste 3
Mount Laurel, NJ 08054-2936

Mailing address

1200 S Church St Ste 3
Mount Laurel, NJ 08054-2936
Phone (856) 359-4799

Other identifiers 1

IdentifierTypeStateIssuer
691828MedicaidNJ

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address Admin@pjohealth.com Health Information Exchange (HIE)
CONNECT URL Pjohealth.com
CONNECT URL Adminpjohealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221115000056 NJ Part B Supplier - Clinic/Group Practice 4385012897 Receives reassigned benefits from 1 practitioner
Practice locations: Mount Laurel, NJ

National Provider Directory

National Provider Directory

Locations

1200 S Church St
Ste 3
Mount Laurel, NJ 08054
Phone (856) 359-4799

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1587859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724284800000",
    "number": "1548880941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S CHURCH ST STE 3",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080542936",
            "telephone_number": "856-359-4799",
            "fax_number": "856-249-9068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S CHURCH ST STE 3",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080542936",
            "telephone_number": "856-359-4799",
            "fax_number": "856-249-9068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PJO HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-26",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A",
        "authorized_official_last_name": "OSBORNE",
        "authorized_official_first_name": "JULIETTEOSBORNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "856-356-4799",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "691828",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Admin@pjohealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct messaging",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1200 S Church St Ste 21B",
            "city": "Mount Laurel",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080542936",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Pjohealth.com",
            "affiliation": "N",
            "address_1": "1200 S Church St Ste 3",
            "city": "Mount Laurel",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080542936",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Adminpjohealth.com",
            "affiliation": "N",
            "address_1": "1200 S Church St Ste 3",
            "city": "Mount Laurel",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080542936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.