Individual provider Active NPI

Rachel Conry

  • Psychiatric/Mental Health Nurse Practitioner
  • Cedar Knolls, NJ
National Provider Identifier
1629420914
Registry record updated Sep 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ00660600 Issued in NJ
Practice address
14 Ridgedale Ave
Ste 103
Cedar Knolls, NJ 07927-1106
Phone
(973) 295-6335
NPI assigned
Jul 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 402040 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ00660600 NJ Primary

Addresses

Primary practice location

14 Ridgedale Ave
Ste 103
Cedar Knolls, NJ 07927-1106

Mailing address

14 Ridgedale Ave
Ste 103
Cedar Knolls, NJ 07927-1106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00660600NJMDPsychiatric/Mental Health Nurse Practitioner
402040NYMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474416000000",
    "number": "1629420914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 RIDGEDALE AVE",
            "address_2": "STE 103",
            "city": "CEDAR KNOLLS",
            "state": "NJ",
            "postal_code": "079271106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 RIDGEDALE AVE",
            "address_2": "STE 103",
            "city": "CEDAR KNOLLS",
            "state": "NJ",
            "postal_code": "079271106",
            "telephone_number": "973-295-6335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRY",
        "first_name": "RACHEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2016-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402040",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00660600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Knolls, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; 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.