Individual provider Active NPI

Kelly Man

  • Psychiatric/Mental Health Nurse Practitioner
  • Eatontown, NJ
National Provider Identifier
1861308306
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ15618700 Issued in NJ
Practice address
61 James Way
Eatontown, NJ 07724-2272
Phone
(732) 724-1234
NPI assigned
Aug 24, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ15618700 NJ Primary

Addresses

Primary practice location

61 James Way
Eatontown, NJ 07724-2272

Mailing address

23 Seaview Ave
Keansburg, NJ 07734-1225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1787529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1861308306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 SEAVIEW AVE",
            "city": "KEANSBURG",
            "state": "NJ",
            "postal_code": "077341225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 JAMES WAY",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077242272",
            "telephone_number": "732-724-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAN",
        "first_name": "KELLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-24",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15618700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eatontown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.