Individual provider Active NPI

Christine Villamayor, APN

  • Family Nurse Practitioner
  • Bayonne, NJ
National Provider Identifier
1710633201
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ01467200 Issued in NJ
Practice address
523 Broadway
Bayonne, NJ 07002-3735
Phone
(201) 649-1190
Fax
(201) 730-0433
NPI assigned
Feb 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 26NR21022800 NJ
Nurse Practitioner 363L00000X NUR2023000117 NJ
Family Nurse Practitioner 363LF0000X 26NJ01467200 NJ Primary

Addresses

Primary practice location

523 Broadway
Bayonne, NJ 07002-3735

Mailing address

523 Broadway
Bayonne, NJ 07002-3735
Phone (201) 649-1190

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
I20230823004002 NJ Practitioner - Nurse Practitioner 4880057892 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NR21022800NJMDRegistered Nurse
NUR2023000117NJMDNurse Practitioner
26NJ01467200NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jake Gurland, M.D. CurrentSince Jul 11, 2024 Accepting new patients
Hudson MD Group CurrentSince Jun 1, 2023 Accepting new patients
David W. Lee MD PA PastSince Feb 6, 2007 Accepting new patients

Locations

523 Broadway
Bayonne, NJ 07002
Phone (201) 649-1190

1625 Anderson Ave
Ste 204
Fort Lee, NJ 07024
Phone (201) 224-0011

205 9th St
Jersey City, NJ 07302
Phone (201) 420-1411

9 Hospital Dr
Ste A22
Toms River, NJ 08755
Phone (973) 429-1300

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1710633201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023735",
            "telephone_number": "201-649-1190",
            "fax_number": "201-730-0433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023735",
            "telephone_number": "201-649-1190",
            "fax_number": "201-730-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAMAYOR",
        "first_name": "CHRISTINE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-23",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR21022800",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "NUR2023000117",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01467200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

Verify at the official NPI Registry.