NPIMap

Organization Active NPI

Coordinated Supports LLC

  • Supports Brokerage Agency
  • Southampton, NJ
National Provider Identifier
1649024621
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Supports Brokerage AgencyTaxonomy code 251X00000X
Legal business name
COORDINATED SUPPORTS LLC
Practice address
83 Buckingham Drive
Southampton, NJ 08088-1103
Phone
(609) 321-3103
NPI assigned
Apr 15, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

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

Authorized official

Name
Ashlee DavidsonNPI 1265114649
Title
Executive Director
Phone
(609) 321-3103

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Supports Brokerage Agency 251X00000X Primary

Addresses

Primary practice location

83 Buckingham Drive
Southampton, NJ 08088-1103

Mailing address

83 Buckingham Drive
Southampton, NJ 08088-1103
Phone (609) 321-3103

National Provider Directory

National Provider Directory

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": "1713139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713139200000",
    "number": "1649024621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 BUCKINGHAM DRIVE",
            "city": "SOUTHAMPTON",
            "state": "NJ",
            "postal_code": "080881103",
            "telephone_number": "609-321-3103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 BUCKINGHAM DRIVE",
            "city": "SOUTHAMPTON",
            "state": "NJ",
            "postal_code": "080881103",
            "telephone_number": "609-321-3103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COORDINATED SUPPORTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "ASHLEE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "609-321-3103"
    },
    "taxonomies": [
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southampton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; 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.