Jessica Lila Ivan, RRT

Primary specialty

Pulmonary Function Technologist Registered Respiratory TherapistTaxonomy code 2279P1006X

License

43ZA00512900 Issued in NJ

Practice address

300 Madison Ave FL 3
Madison, NJ 07940-1868

Phone

(973) 822-2772

NPI assigned

Mar 3, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1646265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1730836313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 WEISS TER",
            "city": "RARITAN",
            "state": "NJ",
            "postal_code": "088691631",
            "telephone_number": "908-397-8242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MADISON AVE FL 3",
            "city": "MADISON",
            "state": "NJ",
            "postal_code": "079401868",
            "telephone_number": "973-822-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVAN",
        "first_name": "JESSICA",
        "middle_name": "LILA",
        "credential": "RRT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-03",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2279P1006X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Respiratory Therapist, Registered, Pulmonary Function Technologist",
            "state": "NJ",
            "license": "43ZA00512900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Madison, NJ
• Pulmonary Function Technologist Registered Respiratory Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; 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.