Active NPI
John Obrien, RN
- Administrator Registered Nurse
- Passaic, NJ
National Provider Identifier
1902476005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Administrator Registered Nurse
- License
- 26NO09809300
- Practice address
- 333 Passaic St
Passaic, NJ 07055-5814 - Phone
- (973) 365-5656
- Fax
- (973) 365-5677
- NPI assigned
- Jun 30, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Administrator Registered Nurse | 163WA2000X | 26NO09809300 | NJ | Primary |
Addresses
Primary practice location
333 Passaic St
Passaic, NJ 07055-5814
Mailing address
333 Passaic St
Passaic, NJ 07055-5814
Phone (973) 365-5656
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Passaic | Health Information Exchange (HIE) | |
| CONNECT URL | Passaic | Direct |
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NO09809300 | NJ | MD | Administrator Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625011200000",
"number": "1902476005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 PASSAIC ST",
"city": "PASSAIC",
"state": "NJ",
"postal_code": "070555814",
"telephone_number": "973-365-5656",
"fax_number": "973-365-5677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 PASSAIC ST",
"city": "PASSAIC",
"state": "NJ",
"postal_code": "070555814",
"telephone_number": "973-365-5656",
"fax_number": "973-365-5677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBRIEN",
"first_name": "JOHN",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-06-30",
"last_updated": "2021-06-30",
"certification_date": "2021-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "163WA2000X",
"taxonomy_group": "",
"desc": "Registered Nurse, Administrator",
"state": "NJ",
"license": "26NO09809300",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Passaic",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "333 Passaic St",
"city": "Passaic",
"state": "NJ",
"country_code": "US",
"postal_code": "070555814",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Passaic",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "333 Passaic St",
"city": "Passaic",
"state": "NJ",
"country_code": "US",
"postal_code": "070555814",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Passaic, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.