Active NPI
Joanna M Bird, M.D.
- Psychiatry Physician
- Chatham, NJ
National Provider Identifier
1720202658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 25MA08657200
- Practice address
- 10 Fairmount Ave
Chatham, NJ 07928-2343 - Phone
- (973) 822-0222
- Fax
- (973) 822-0225
- NPI assigned
- Apr 12, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 230241 | NY | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 25MA08657200 | NJ | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 230241 | NY | |
| Psychiatry Physician | 2084P0800X | 25MA08657200 | NJ | Primary |
Addresses
Primary practice location
10 Fairmount Ave
Chatham, NJ 07928-2343
Mailing address
10 Fairmount Ave
Chatham, NJ 07928-2343
Phone (973) 822-0222
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jul 1, 2019 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626134400000",
"number": "1720202658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 FAIRMOUNT AVE",
"city": "CHATHAM",
"state": "NJ",
"postal_code": "079282343",
"telephone_number": "973-822-0222",
"fax_number": "973-822-0225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 FAIRMOUNT AVE",
"city": "CHATHAM",
"state": "NJ",
"postal_code": "079282343",
"telephone_number": "973-822-0222",
"fax_number": "973-822-0225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BIRD",
"first_name": "JOANNA",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-12",
"last_updated": "2021-07-13",
"certification_date": "2021-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "230241",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "NJ",
"license": "25MA08657200",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "NY",
"license": "230241",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NJ",
"license": "25MA08657200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chatham, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.