Individual provider Active NPI

Joni Lynn Prentice, NP

  • Nurse Practitioner
  • Neptune, NJ
National Provider Identifier
1669813390
Registry record updated Jul 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ00466300 Issued in NJ
Practice address
1945 Corlies Avenue
Neptune, NJ 07753
Phone
(732) 775-5500
NPI assigned
Jul 10, 2013
Last updated
Jul 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ00466300 NJ Primary
Adult Health Nurse Practitioner 363LA2200X A1209076 NJ

Addresses

Primary practice location

1945 Corlies Avenue
Neptune, NJ 07753

Mailing address

2113 First Ave
P.O. Bo 254
Allenwood, NJ 08720-7020
Phone (732) 330-2792

Other practice location 1

2113 First Ave
P.O. Bo 254
Allenwood, NJ 08720-7020
Phone (732) 330-2792

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181017002459 NJ Order and Referring Only - Nurse Practitioner 3476805599

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00466300NJMDNurse Practitioner
A1209076NJMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1373414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532044800000",
    "number": "1669813390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2113 FIRST AVE",
            "address_2": "P.O. BO 254",
            "city": "ALLENWOOD",
            "state": "NJ",
            "postal_code": "087207020",
            "telephone_number": "732-330-2792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 CORLIES AVENUE",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "07753",
            "telephone_number": "732-775-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2113 First Ave",
            "address_2": "P.O. Bo 254",
            "address_purpose": "LOCATION",
            "city": "Allenwood",
            "state": "NJ",
            "postal_code": "087207020",
            "country_code": "US",
            "telephone_number": "732-330-2792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRENTICE",
        "first_name": "JONI",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-10",
        "last_updated": "2018-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00466300",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "A1209076",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neptune, NJ

Sources for this page

Verify at the official NPI Registry.