Individual provider Active NPI

Tony L Staggers

  • Pastoral Counselor
  • Jersey City, NJ
National Provider Identifier
1710596374
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pastoral CounselorTaxonomy code 101YP1600X
Practice address
155 Bayview Ave
Jersey City, NJ 07305-3306
Phone
(201) 681-0783
NPI assigned
Jul 29, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral Counselor 101YP1600X
Pastoral Counselor 101YP1600X NJ Primary

Addresses

Primary practice location

155 Bayview Ave
Jersey City, NJ 07305-3306

Mailing address

155 Bayview Ave
Jersey City, NJ 07305-3306
Phone (201) 681-0783

Other identifiers 2

IdentifierTypeStateIssuer
0MedicaidNJ
00MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1710596374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 BAYVIEW AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073053306",
            "telephone_number": "201-681-0783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 BAYVIEW AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073053306",
            "telephone_number": "201-681-0783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAGGERS",
        "first_name": "TONY",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-29",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.