Instride Health NJ PC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

INSTRIDE HEALTH NJ PC

Practice address

820 Bear Tavern Rd
Ewing, NJ 08628-1021

Phone

(855) 438-8331

NPI assigned

Aug 16, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Mona Potter, MDNPI 1235113010

Title

President and Chief Medical Officer

Phone

(615) 424-3398

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mona Patel Potter, MD

  • Psychiatry Physician
  • Wellesley Hills, MA
  • NPI 1235113010
  NPD Authorized official
• Meghan Fitzpatrick, LMHC

  • Mental Health Counselor
  • Lexington, MA
  • NPI 1740866698
  NPD

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666915200000",
    "number": "1972221935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 LOCKE LN",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024202706",
            "telephone_number": "615-424-3398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 BEAR TAVERN RD",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086281021",
            "telephone_number": "855-438-8331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSTRIDE HEALTH NJ PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-16",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "MONA",
        "authorized_official_title_or_position": "PRESIDENT AND CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "615-424-3398",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adolescent and Children Mental Health Clinic/Center in Ewing, NJ
• Providers in Ewing, NJ by specialty
• Adolescent and Children Mental Health Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; 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.