Individual provider Active NPI

Joseph Chidiebere Ekenta, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Trenton, NJ
National Provider Identifier
1972203131
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ01451800 Issued in NJ
Practice address
100 Sullivan Way
Trenton, NJ 08628
Phone
(609) 633-1501
NPI assigned
Mar 7, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 26NJ01451800 NJ Primary

Addresses

Primary practice location

100 Sullivan Way
Trenton, NJ 08628

Mailing address

100 Sullivan Way
Trenton, NJ 08628
Phone (609) 633-1501

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
I20230630000031 NJ Practitioner - Nurse Practitioner 1052770625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Success TMS Professional Services New Jersey LLCGroup PAC ID 9638592249, 17 clinicians

Practice addresses (Care Compare)

1950 Route 70 E
Suite 201
Cherry Hill, NJ 08003-2128
Phone (973) 954-4592

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ01451800NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Success TMS Professional Services New Jersey LLC CurrentSince Apr 24, 2023 Accepting new patients

Locations

1615 S Congress Ave
Ste 200
Delray Beach, FL 33445

1950 Route 70 E
Ste 201
Cherry Hill, NJ 08003
Phone (856) 229-0138

240 Central Ave
East Orange, NJ 07018
Phone (973) 414-3473

1 University Plz
Ste 408
Hackensack, NJ 07601

405 Hurffvle CR Keys Rd
Ste 202
Sewell, NJ 08080
Phone (856) 566-7093

106 Apple St
Ste 106
Tinton Falls, NJ 07724
Phone (732) 784-3679

151 Fries Mill Rd
Ste 101
Turnersville, NJ 08012
Phone (856) 229-0138

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1678147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1972203131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SULLIVAN WAY",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "08628",
            "telephone_number": "609-633-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SULLIVAN WAY",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "08628",
            "telephone_number": "609-633-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKENTA",
        "first_name": "JOSEPH",
        "middle_name": "CHIDIEBERE",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-07",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01451800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, NJ

Sources for this page

Verify at the official NPI Registry.