Individual provider Active NPI

Pridy Ning

  • Psychiatric/Mental Health Nurse Practitioner
  • Newark, NJ
National Provider Identifier
1891646253
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ15513100 Issued in NJ
Practice address
550 Broad St Ste 606
Newark, NJ 07102-4537
Phone
(201) 822-1161
NPI assigned
Feb 3, 2026
Last updated
Jun 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 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 26NJ15513100 NJ Primary

Addresses

Primary practice location

550 Broad St Ste 606
Newark, NJ 07102-4537

Mailing address

120 Princeton Rd
Clementon, NJ 08021-3872
Phone (856) 378-3089

Other practice location 1

120 Princeton Rd
Clementon, NJ 08021-3872
Phone (856) 378-3089

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260325004122 NJ Practitioner - Nurse Practitioner 5698250801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
JLS Medical PCGroup PAC ID 7719342005, 53 clinicians

Practice addresses (Care Compare)

1030 Kings Hwy N
Suite 210 Mywellbrook Health
Cherry Hill, NJ 08034-1907
Phone (201) 822-1161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NJ15513100NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
JLS Medical PC Psychiatric/Mental Health PastSince Mar 3, 2023 Accepting new patients
Bancroft, a New Jersey Nonprofit Corporation Past Accepting new patients

Organizations & group practices 2

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": "1770076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1891646253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 PRINCETON RD",
            "city": "CLEMENTON",
            "state": "NJ",
            "postal_code": "080213872",
            "telephone_number": "856-378-3089",
            "fax_number": "185-637-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 BROAD ST STE 606",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071024537",
            "telephone_number": "201-822-1161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Princeton Rd",
            "address_purpose": "LOCATION",
            "city": "Clementon",
            "state": "NJ",
            "postal_code": "080213872",
            "country_code": "US",
            "telephone_number": "856-378-3089",
            "fax_number": "185-637-8308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NING",
        "first_name": "PRIDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-03",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15513100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.