Monmouth County Pain Management & Wellness Center LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

25MA08847600 Issued in NJ

Legal business name

MONMOUTH COUNTY PAIN MANAGEMENT & WELLNESS CENTER LLC

Practice address

1131 Broad St Ste 104
Shrewsbury, NJ 07702-4334

Phone

(908) 692-9833

NPI assigned

Jan 6, 2014

Organization subpart

No

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

Authorized official

Name

Nicole Keegan, MD

Title

MD

Phone

(908) 692-9833

Specialties & licenses 1

Addresses

Tax ID family

Monmouth County Pain Management and Wellness Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Monmouth County Pain Management & Wellness Center

  • Nurse Practitioner
  • Shrewsbury, NJ
  • NPI 1609205269
  NPD tax ID
• Monmouth County Pain Management and Wellness Center

  • Pain Clinic/Center
  • Shrewsbury, NJ
  • NPI 1710308937
  NPD tax ID

Locations

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

{
    "created_epoch": "1388966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407801600000",
    "number": "1811319189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 BROAD ST STE 104",
            "city": "SHREWSBURY",
            "state": "NJ",
            "postal_code": "077024334",
            "telephone_number": "908-692-9833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 BROAD ST STE 104",
            "city": "SHREWSBURY",
            "state": "NJ",
            "postal_code": "077024334",
            "telephone_number": "908-692-9833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONMOUTH COUNTY PAIN MANAGEMENT & WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-06",
        "last_updated": "2014-08-12",
        "status": "A",
        "authorized_official_last_name": "KEEGAN",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "908-692-9833",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NJ",
            "license": "25MA08847600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miracles in Motion Physical Therapy LLC
• Pamela Mizrahi, OTR/L
• Domenica M Modica
• Monmouth County ICU Consortium, LLC
• Monmouth County Pain Management & Wellness Center
• Monmouth County Pain Management and Wellness Center
• Monmouth ENT Associates, LLC
• Monmouth Family Chiropractic
• Monmouth Family Chiropractic, PC
• Monmouth Pain and Rehabiliation PC

• Medical Specialty Clinic/Center in Shrewsbury, NJ
• Providers in Shrewsbury, NJ by specialty
• Medical Specialty Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2014; 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.