Individual provider Active NPI

Jennifer Roach Zylstra, LSW

  • Social Worker
  • Asbury Park, NJ
National Provider Identifier
1720689375
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
44SL06597400 Issued in NJ
Practice address
705 Summerfield Ave
Asbury Park, NJ 07712-6921
Phone
(732) 774-6886
Fax
(732) 774-8809
NPI assigned
Nov 2, 2020
Last updated
Nov 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 44SL06597400 NJ Primary

Addresses

Primary practice location

705 Summerfield Ave
Asbury Park, NJ 07712-6921

Mailing address

PO Box 123
Roosevelt, NJ 08555-0123
Phone (609) 994-7884

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

State licenses

LicenseStateTypeSpecialty
44SL06597400NJMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1604275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1720689375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 123",
            "city": "ROOSEVELT",
            "state": "NJ",
            "postal_code": "085550123",
            "telephone_number": "609-994-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 SUMMERFIELD AVE",
            "city": "ASBURY PARK",
            "state": "NJ",
            "postal_code": "077126921",
            "telephone_number": "732-774-6886",
            "fax_number": "732-774-8809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZYLSTRA",
        "first_name": "JENNIFER",
        "middle_name": "ROACH",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-02",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL06597400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Asbury Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.