Active NPI
Mario Parker
- In Home Supportive Care Agency
- Montclair, NJ
National Provider Identifier
1730788795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- License
- HP0140500
- Practice address
- 571 Park St
Montclair, NJ 07043-2027 - Phone
- (973) 495-4322
- Fax
- (888) 912-7480
- NPI assigned
- Oct 21, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | HP0140500 | NJ | Primary |
Addresses
Primary practice location
571 Park St
Montclair, NJ 07043-2027
Mailing address
571 Park St
Montclair, NJ 07043-2027
Phone (973) 783-4663
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
| License | State | Type | Specialty |
|---|---|---|---|
| HP0140500 | NJ | MD | In Home Supportive Care Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603238400000",
"number": "1730788795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "571 PARK ST",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070432027",
"telephone_number": "973-783-4663",
"fax_number": "888-912-7480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "571 PARK ST",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070432027",
"telephone_number": "973-495-4322",
"fax_number": "888-912-7480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKER",
"first_name": "MARIO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-10-21",
"last_updated": "2020-10-21",
"certification_date": "2020-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "NJ",
"license": "HP0140500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montclair, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.