Albatross to Phoenix Psychiatry LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

ALBATROSS TO PHOENIX PSYCHIATRY LLC

Practice address

111 Town Square PL Ste 1238
Jersey City, NJ 07310-1810

Phone

(201) 757-2531

NPI assigned

Feb 19, 2024

Last updated

Feb 19, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ricky James Jewell, APNNPI 1013673912

Title

Advanced Practice Nurse

Phone

(862) 774-4562

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ricky James Jewell, DNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Edison, NJ
  • NPI 1013673912
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708300800000",
    "number": "1801651864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 TOWN SQUARE PL",
            "address_2": "SUITE 1238 PMB 801874",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 TOWN SQUARE PL STE 1238",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073101810",
            "telephone_number": "201-757-2531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBATROSS TO PHOENIX PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A",
        "authorized_official_last_name": "JEWELL",
        "authorized_official_first_name": "RICKY",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "ADVANCED PRACTICE NURSE",
        "authorized_official_telephone_number": "862-774-4562",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chiamaka Chienyem Alagbogu, DNP
• Parvez Alam, MD
• Ghaleb Alameer, D.P.M.
• Alana Med Invalid Coach
• Yisel Alaoui, LCADC
• Martin Albiez, M.A., L.P.C.
• Marra Alcantara, D.D.S.
• Rafael Alcantara
• Ron-Marvin Alcantara
• Gabriel Aleksandryants, DMD

• Psychiatric/Mental Health Nurse Practitioner in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; 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.