NPIMap

Organization Active NPI

Rutgers Nursing Faculty Practice

  • Nurse Practitioner
  • Newark, NJ
National Provider Identifier
1669737755
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
RUTGERS NURSING FACULTY PRACTICE
Practice address
274 S Orange Ave FL 3
Newark, NJ 07103-2419
Phone
(973) 732-6040
Fax
(862) 902-7874
NPI assigned
Jul 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Authorized official

Name
Andrea Norberg, DNP,MS,RN
Title
Ceo
Phone
(973) 972-5141

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

274 S Orange Ave FL 3
Newark, NJ 07103-2419

Mailing address

274 S Orange Ave FL 3
Newark, NJ 07103-2419
Phone (973) 732-6040

Other identifiers 1

IdentifierTypeStateIssuer
0742791MedicaidNJ

Other names 1

  • Rutgers Community Health Center Doing business as

National Provider Directory

National Provider Directory

Locations

274 S Orange Ave
Fl 3
Newark, NJ 07103
Phone (973) 732-6040

274 S Orange Ave
#3
Newark, NJ 07103

65 Bergen St
Rm 822
Newark, NJ 07107

Practitioners & affiliated clinicians

Practitioners 9

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": "1341446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638316800000",
    "number": "1669737755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "274 S ORANGE AVE FL 3",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032419",
            "telephone_number": "973-732-6040",
            "fax_number": "862-902-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "274 S ORANGE AVE FL 3",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032419",
            "telephone_number": "973-732-6040",
            "fax_number": "862-902-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUTGERS NURSING FACULTY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-05",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A",
        "authorized_official_last_name": "NORBERG",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "973-972-5141",
        "authorized_official_credential": "DNP,MS,RN"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0742791",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rutgers Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rutgers Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 1, 2021; 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.