Individual provider Active NPI

Joan Gale Yetman, NP

  • Gerontology Nurse Practitioner
  • Toms River, NJ
National Provider Identifier
1902139041
Registry record updated Sep 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
26NN06189200 Issued in NJ
Practice address
803 Main St
Toms River, NJ 08753-6699
Phone
(732) 557-0100
NPI assigned
Sep 8, 2009
Last updated
Sep 8, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 26NN06189200 NJ Primary

Addresses

Primary practice location

803 Main St
Toms River, NJ 08753-6699

Mailing address

803 Main St
Toms River, NJ 08753-6699
Phone (732) 557-0100

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NN06189200NJMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Medical Care Center LLC Past Accepting new patients
Shore Continence Center, P.C. Gerontology 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": "1252368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252368000000",
    "number": "1902139041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 MAIN ST",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087536699",
            "telephone_number": "732-557-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 MAIN ST",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087536699",
            "telephone_number": "732-557-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YETMAN",
        "first_name": "JOAN",
        "middle_name": "GALE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-08",
        "last_updated": "2009-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NN06189200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toms River, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2009; 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.