Active NPI
Xavier Munden
- Clinical Exercise Physiologist
- Newark, NJ
National Provider Identifier
1780059196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Exercise Physiologist
- Practice address
- 380 Mount Prospect Ave Apt 8C
Newark, NJ 07104-2141 - Phone
- (757) 582-4763
- NPI assigned
- Dec 10, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Exercise Physiologist | 224Y00000X | Primary | ||
| Recreation Therapist | 225800000X |
Addresses
Primary practice location
380 Mount Prospect Ave Apt 8C
Newark, NJ 07104-2141
Mailing address
380 Mount Prospect Ave Apt 8C
Newark, NJ 07104-2141
Phone (757) 582-4763
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449705600000",
"number": "1780059196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "380 MOUNT PROSPECT AVE APT 8C",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071042141",
"telephone_number": "757-582-4763"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "380 MOUNT PROSPECT AVE APT 8C",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071042141",
"telephone_number": "757-582-4763"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUNDEN",
"first_name": "XAVIER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-12-10",
"last_updated": "2015-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "224Y00000X",
"taxonomy_group": "",
"desc": "Clinical Exercise Physiologist",
"state": null,
"license": null,
"primary": true
},
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.