NPIMap

Organization Active NPI

Unlocked Potential, LLC

Doing business as Unlocked Potential

  • Child Intellectual and/or Developmental Disabilities Respite Care
  • Middlesex, NJ
National Provider Identifier
1992242796
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child Intellectual and/or Developmental Disabilities Respite CareTaxonomy code 385HR2060X
Legal business name
UNLOCKED POTENTIAL, LLC
Doing business as
Unlocked Potential
Practice address
331 Dorn Ave
Middlesex, NJ 08846-1117
Phone
(732) 339-3100
Fax
(732) 601-8715
NPI assigned
Jan 31, 2017
Last updated
Jan 31, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2017

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

Authorized official

Name
Ms. Kimberly Keyes, LCSWNPI 1962175661
Title
Owner/Executive Director
Phone
(732) 339-3100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X NJ Primary

Addresses

Primary practice location

331 Dorn Ave
Middlesex, NJ 08846-1117

Mailing address

331 Dorn Ave
Middlesex, NJ 08846-1117
Phone (732) 339-3100

Other identifiers 1

IdentifierTypeStateIssuer
1508269911MedicaidNJ

Other names 1

  • Unlocked Potential Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Unlocked Potential2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1485820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485820800000",
    "number": "1992242796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 DORN AVE",
            "city": "MIDDLESEX",
            "state": "NJ",
            "postal_code": "088461117",
            "telephone_number": "732-339-3100",
            "fax_number": "732-601-8715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 DORN AVE",
            "city": "MIDDLESEX",
            "state": "NJ",
            "postal_code": "088461117",
            "telephone_number": "732-339-3100",
            "fax_number": "732-601-8715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNLOCKED POTENTIAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-31",
        "last_updated": "2017-01-31",
        "status": "A",
        "authorized_official_last_name": "KEYES",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "OWNER/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "732-339-3100",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508269911",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Unlocked Potential",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Middlesex, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; 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.