Hackensack Meridian Ambulatory Care, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

HACKENSACK MERIDIAN AMBULATORY CARE, INC

Doing business as

Meridian Subacute Rehabilitation

Practice address

1725 Meridian TRL
Wall Township, NJ 07719-3869

Phone

(732) 312-1800

NPI assigned

Oct 13, 2017

Last updated

Dec 27, 2021By 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

Richard Hand

Title

Senior Finance Administration

Phone

(732) 481-8529

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Meridian Subacute Rehabilitation Doing business as

Locations

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

{
    "created_epoch": "1507852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640563200000",
    "number": "1841701117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3349 HWY 138 STE A",
            "city": "WALL TOWNSHIP",
            "state": "NJ",
            "postal_code": "077199671",
            "telephone_number": "732-751-3624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 MERIDIAN TRL",
            "city": "WALL TOWNSHIP",
            "state": "NJ",
            "postal_code": "077193869",
            "telephone_number": "732-312-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HACKENSACK MERIDIAN AMBULATORY CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-13",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A",
        "authorized_official_last_name": "HAND",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "SENIOR FINANCE ADMINISTRATION",
        "authorized_official_telephone_number": "732-481-8529"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0626511",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "315501",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meridian Subacute Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Meridian Subacute Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Blair Rachel Gumnic, D.O.
• Michael J Hackett, ATR CSCS
• Thomas Everett Hackett, DO
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• Kim Lee Hart, LCADC
• Joseph Robert Harvey

• Skilled Nursing Facility in Wall Township, NJ
• Providers in Wall Township, NJ by specialty
• Skilled Nursing Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; 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.