Jersey Shore Medical Associates PC

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

26NJ00453900 Issued in NJ

Legal business name

JERSEY SHORE MEDICAL ASSOCIATES PC

Practice address

1028 Hooper Ave
Toms River, NJ 08753-8321

Phone

(732) 202-6850

NPI assigned

Mar 14, 2014

Organization subpart

Yes

Parent organization

MEDVANTX, INC.As reported in NPPES

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

Authorized official

Name

Kenny Heine

Title

VP of Operations

Phone

(858) 964-1506

Specialties & licenses 1

Addresses

Other names 1

• Meridian-After Hours Immediate Care- Toms River Doing business as

Part of

Tri - State Medical Group Inc

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

{
    "created_epoch": "1394755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402963200000",
    "number": "1578989596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 HOOPER AVE",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087538321",
            "telephone_number": "732-202-6850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY SHORE MEDICAL ASSOCIATES PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2014-03-14",
        "last_updated": "2014-06-17",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "858-964-1506"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NJ",
            "license": "26NJ00453900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meridian-After Hours Immediate Care- Toms River",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jersey Emergency Medicine Specialists, PC
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• Jersey Shore Behavioral Therapy LLC
• Jersey Shore Counseling, LLC
• Jersey Shore Myofascial Release Center
• Jersey Shore Nutrition
• Jersey Shore Podiatry ,LLC
• Jersey Shore Spine LLC
• Jersey Shore Surgery and Vein Center, LLC

• Non-Pharmacy Dispensing Site in Toms River, NJ
• Providers in Toms River, NJ by specialty
• Non-Pharmacy Dispensing Site in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; 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.