Organization Active NPI

Theos Health Care LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Maplewood, NJ
National Provider Identifier
1750073169
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
THEOS HEALTH CARE LLC
Practice address
1560 Springfield Ave
Maplewood, NJ 07040-2414
Phone
(848) 256-9392
Fax
(908) 402-4846
NPI assigned
May 24, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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

Authorized official

Name
Ms. Marie Juline CherubinNPI 1245975861
Title
Owner
Phone
(862) 452-2721

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1560 Springfield Ave
Maplewood, NJ 07040-2414

Mailing address

1560 Springfield Ave
Maplewood, NJ 07040-2414
Phone (848) 256-9392

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230706000418 NJ Part B Supplier - Clinic/Group Practice 3072972223 Receives reassigned benefits from 1 practitioner
Practice locations: Maplewood, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695340800000",
    "number": "1750073169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 SPRINGFIELD AVE",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070402414",
            "telephone_number": "848-256-9392",
            "fax_number": "908-402-4846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 SPRINGFIELD AVE",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070402414",
            "telephone_number": "848-256-9392",
            "fax_number": "908-402-4846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEOS HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A",
        "authorized_official_last_name": "CHERUBIN",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "JULINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "862-452-2721",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.