NPIMap

Organization Active NPI

Monmouth County Pain Management & Wellness Center

  • Nurse Practitioner
  • Shrewsbury, NJ
National Provider Identifier
1609205269
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1164752077 Issued in NJ
Legal business name
MONMOUTH COUNTY PAIN MANAGEMENT & WELLNESS CENTER
Practice address
1131 Broad St
Shrewsbury, NJ 07702-4329
Phone
(917) 753-5354
NPI assigned
Nov 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

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

Authorized official

Name
Jennifer Haynes
Title
Member
Phone
(917) 753-5354

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X 1164752077 NJ Primary

Addresses

Primary practice location

1131 Broad St
Shrewsbury, NJ 07702-4329

Mailing address

1131 Broad St
Shrewsbury, NJ 07702-4329

National Provider Directory

National Provider Directory
Tax ID family
Monmouth County Pain Management and Wellness Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383523200000",
    "number": "1609205269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 BROAD ST",
            "city": "SHREWSBURY",
            "state": "NJ",
            "postal_code": "077024329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 BROAD ST",
            "city": "SHREWSBURY",
            "state": "NJ",
            "postal_code": "077024329",
            "telephone_number": "917-753-5354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONMOUTH COUNTY PAIN MANAGEMENT & WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-04",
        "last_updated": "2013-11-04",
        "status": "A",
        "authorized_official_last_name": "HAYNES",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "917-753-5354"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "1164752077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shrewsbury, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; 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.