NPIMap

Organization Active NPI

Ocean County Family Care, P.a.

  • Internal Medicine Physician
  • Jackson, NJ
National Provider Identifier
1821019787
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
OCEAN COUNTY FAMILY CARE, P.A.
Practice address
2290 W County Line Rd
Jackson, NJ 08527-2267
Phone
(732) 942-4455
Fax
(732) 942-4459
NPI assigned
Jul 23, 2006
Last updated
Jan 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2008

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

Authorized official

Name
Joanne McKeown
Title
Administrator
Phone
(732) 942-4455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

2290 W County Line Rd
Jackson, NJ 08527-2267

Mailing address

2290 W County Line Rd
Jackson, NJ 08527-2267
Phone (732) 942-4455

Other identifiers 1

IdentifierTypeStateIssuer
7060807MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040420000335 NJ Part B Supplier - Clinic/Group Practice 6800881673 Receives reassigned benefits from 12 practitioners
Practice locations: Brick, NJ; Jackson, NJ; Ship Bottom, NJ; Toms River, NJ

National Provider Directory

National Provider Directory

Locations

9 Mule Rd
Ste E10
Toms River, NJ 08755
Phone (732) 370-4222

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
HarrogateLakewood, NJ, CCN 315262 Skilled nursing facility Adp of the SNF Nov 1, 1993

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 46

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.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201564800000",
    "number": "1821019787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2290 W COUNTY LINE RD",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085272267",
            "telephone_number": "732-942-4455",
            "fax_number": "732-942-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2290 W COUNTY LINE RD",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085272267",
            "telephone_number": "732-942-4455",
            "fax_number": "732-942-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCEAN COUNTY FAMILY CARE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2008-01-29",
        "status": "A",
        "authorized_official_last_name": "MCKEOWN",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "732-942-4455"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7060807",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, NJ

Sources for this page

Verify at the official NPI Registry.