Organization Active NPI

Wound Care Specialist of New Jersey

  • Nurse Practitioner
  • Bayonne, NJ
National Provider Identifier
1760797930
Registry record updated Apr 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
WOUND CARE SPECIALIST OF NEW JERSEY
Practice address
824 Kennedy Blvd.
Bayonne, NJ 07002-2212
Phone
(917) 829-5301
Fax
(888) 796-5637
NPI assigned
Aug 12, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2011

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

Authorized official

Name
Jansen Macalindong
Title
Consultant
Phone
(917) 829-5301

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X Primary
Adult Health Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LA2200X

Addresses

Primary practice location

824 Kennedy Blvd.
Bayonne, NJ 07002-2212

Mailing address

824 Kennedy Blvd
Bayonne, NJ 07002-2872

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": "1281571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303516800000",
    "number": "1760797930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 KENNEDY BLVD",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070022872",
            "fax_number": "188-796-5637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 KENNEDY BLVD.",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070022212",
            "telephone_number": "917-829-5301",
            "fax_number": "888-796-5637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOUND CARE SPECIALIST OF NEW JERSEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-12",
        "last_updated": "2011-04-23",
        "status": "A",
        "authorized_official_last_name": "MACALINDONG",
        "authorized_official_first_name": "JANSEN",
        "authorized_official_title_or_position": "CONSULTANT",
        "authorized_official_telephone_number": "917-829-5301"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2011; 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.