Jared Mathew O'Malley, OWNER

Primary specialty

Foster Care AgencyTaxonomy code 253J00000X

License

1114406 Issued in MN

Practice address

3019 18TH St S
Saint Cloud, MN 56301-4734

Phone

(320) 429-2307

NPI assigned

Jan 17, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1673913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1649985490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3019 18TH ST S",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014734",
            "telephone_number": "320-429-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3019 18TH ST S",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014734",
            "telephone_number": "320-429-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'MALLEY",
        "first_name": "JARED",
        "middle_name": "MATHEW",
        "credential": "OWNER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-17",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "MN",
            "license": "1114406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADULT FAMILY FOSTER CARE",
            "identifier": "00000000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua O'Connell
• Brandi Lynn O'Connor, P.A.C
• Joy O'Donnell, RD, LD
• Sally Anne O'Keefe, CMT
• Courtney O'Malley, LPCC, LADC
• Michael Patrick O'Neal, LADC
• Robert M O'Neel
• Kerry Ann O'Neill, RPH, BCOP
• Sarah Heather Ray O'Reilly, LGSW
• Oasis Support Services LLC

• Foster Care Agency in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Foster Care Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; 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.