Individual provider Active NPI

Calutha Myers

  • Registered Nurse
  • Bloomfield, NJ
National Provider Identifier
1861993248
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
26NR08632500 Issued in NJ
Practice address
340 Franklin Street
2ND FL Suite 3
Bloomfield, NJ 07003-3491
Phone
(973) 399-1500
Fax
(973) 488-7149
NPI assigned
Feb 22, 2018
Last updated
May 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 26NR08632500 NJ Primary

Addresses

Primary practice location

340 Franklin Street
2ND FL Suite 3
Bloomfield, NJ 07003-3491

Mailing address

340 Franklin Street
2ND FL Suite 3
Bloomfield, NJ 07003-3491
Phone (973) 399-1500

Other identifiers 1

IdentifierTypeStateIssuer
6095840200MedicaidNJ

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
26NR08632500NJMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
CT Health Care Services CurrentSince May 31, 2020 Accepting new patients

Locations

340 Franklin St
Ste 3
Bloomfield, NJ 07003
Phone (973) 399-1500

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1519257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1861993248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 FRANKLIN STREET",
            "address_2": "2ND FL SUITE 3",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070033491",
            "telephone_number": "973-399-1500",
            "fax_number": "973-488-7149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 FRANKLIN STREET",
            "address_2": "2ND FL SUITE 3",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070033491",
            "telephone_number": "973-399-1500",
            "fax_number": "973-488-7149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "CALUTHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-22",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR08632500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6095840200",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; 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.