Casey Moss

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

1000140 Issued in NJ

Practice address

610 Pemberton Browns Mills Rd
Pemberton, NJ 08068-1537

Phone

(609) 519-1816

Fax

(609) 283-0262

NPI assigned

Jan 20, 2023

Last updated

Jan 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1674172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1902511223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 PEMBERTON BROWNS MILLS RD",
            "city": "PEMBERTON",
            "state": "NJ",
            "postal_code": "080681537",
            "telephone_number": "609-519-1816",
            "fax_number": "609-283-0262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 PEMBERTON BROWNS MILLS RD",
            "city": "PEMBERTON",
            "state": "NJ",
            "postal_code": "080681537",
            "telephone_number": "609-519-1816",
            "fax_number": "609-283-0262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "CASEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-20",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NJ",
            "license": "1000140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUBSTANCE ABUSE REHABILITATION FACILITY",
            "identifier": "1000140",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmoss@maryvillenj.org",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "610 Pemberton Browns Mills Rd",
            "city": "Pemberton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080681537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Merakey New Jersey
• Jaclyn S Merrill, RBT
• Ellen Christine Miller, COTA
• Rosanne V Mirakian, DDS
• Orin H Morrison Jr., CADC
• Kylee Niroda, RBT
• Sophia Nugent
• Chiamaka M Odikpo, RBT
• Amanda J Palombo
• Sarah Parenteau

• Substance Abuse Rehabilitation Facility in Pemberton, NJ
• Providers in Pemberton, NJ by specialty
• Substance Abuse Rehabilitation Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; 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.