Individual provider Active NPI

Donna Terese Petit-Homme, LSW

  • Social Worker
  • Bridgewater, NJ
National Provider Identifier
1831334465
Registry record updated Dec 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
44SL05219400 Issued in NJ
Practice address
500 North Bridge St.
Bridgewater, NJ 08807
Phone
(908) 725-2800
Fax
(908) 704-1790
NPI assigned
Dec 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 44SL05219400 NJ Primary

Addresses

Primary practice location

500 North Bridge St.
Bridgewater, NJ 08807

Mailing address

500 North Bridge St.
Bridgewater, NJ 08807
Phone (908) 725-2800

Other identifiers 3

IdentifierTypeStateIssuer
8363102OtherNJAGENCY MEDICAID NUMBER
527486OtherNJAGENCY MEDICARE NUMBER
0023701OtherNJAGENCY MEDICAID NUMBER

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

State licenses

LicenseStateTypeSpecialty
44SL05219400NJMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1228953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228953600000",
    "number": "1831334465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NORTH BRIDGE ST.",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "08807",
            "telephone_number": "908-725-2800",
            "fax_number": "908-704-1790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 NORTH BRIDGE ST.",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "08807",
            "telephone_number": "908-725-2800",
            "fax_number": "908-704-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETIT-HOMME",
        "first_name": "DONNA",
        "middle_name": "TERESE",
        "name_prefix": "Mrs.",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-11",
        "last_updated": "2008-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL05219400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AGENCY MEDICAID NUMBER",
            "identifier": "8363102",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AGENCY MEDICARE NUMBER",
            "identifier": "527486",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AGENCY MEDICAID NUMBER",
            "identifier": "0023701",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgewater, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2008; 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.