Organization Active NPI

Hydrate Your Way

  • Family Nurse Practitioner
  • Newark, NJ
National Provider Identifier
1669225314
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
HYDRATE YOUR WAY
Practice address
10-12 Scott St Apt 2
Newark, NJ 07102-3493
Phone
(862) 902-3094
NPI assigned
Apr 10, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Authorized official

Name
Joy Shannon, APRN, FNP
Title
Owner/Ceo
Phone
(862) 902-3094

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Infusion Agency 251F00000X
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

10-12 Scott St Apt 2
Newark, NJ 07102-3493

Mailing address

10-12 Scott St Apt 2
Newark, NJ 07102-3493
Phone (862) 902-3094

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1712707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713484800000",
    "number": "1669225314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10-12 SCOTT ST APT 2",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071023493",
            "telephone_number": "862-902-3094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10-12 SCOTT ST APT 2",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071023493",
            "telephone_number": "862-902-3094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYDRATE YOUR WAY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-10",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A",
        "authorized_official_last_name": "SHANNON",
        "authorized_official_first_name": "JOY",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "862-902-3094",
        "authorized_official_credential": "APRN, FNP"
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.