Individual provider Active NPI

Tatanisha Hason, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Blackwood, NJ
National Provider Identifier
1013420298
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ00769500 Issued in NJ
Practice address
400 E Church St
Blackwood, NJ 08012-3910
Phone
(856) 227-6575
Fax
(856) 374-9465
NPI assigned
Nov 10, 2017
Last updated
Jun 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00769500 NJ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ00769500 NJ Primary

Addresses

Primary practice location

400 E Church St
Blackwood, NJ 08012-3910

Mailing address

400 E Church St
Blackwood, NJ 08012-3910
Phone (856) 227-6575

Other practice location 1

532 Old Marlton Pike W
PMB 510
Evesham, NJ 08053-2075
Phone (856) 242-2121

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
I20171206001269 NJ Practitioner - Nurse Practitioner 6406113026 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Extraordinary MindsGroup PAC ID 8224495924, 2 clinicians

Practice addresses (Care Compare)

1120 Delsea Dr N
Glassboro, NJ 08028-1444
Phone (856) 507-2783

532 Old Marlton Pike W
Suite 510
Evesham, NJ 08053-9999
Phone (856) 242-2121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-County Health Connections PC CurrentSince Apr 1, 2020 Accepting new patients
Extraordinary Minds Psychiatric/Mental Health CurrentSince Mar 19, 2023 Accepting new patients
Advocare, LLC CurrentSince Nov 1, 2017 Accepting new patients
Advocare , LLC CurrentSince Nov 1, 2017 Accepting new patients
Tri-County Health Connections PC Past Accepting new patients

Locations

400 E Church St
Blackwood, NJ 08012
Phone (856) 227-6575

1120 Delsea Dr N
Glassboro, NJ 08028
Phone (856) 205-7071

1120 Delsea Dr N
Fl 2
Glassboro, NJ 08028
Phone (856) 595-9136

1120 Delsea Dr N
Fl Second
Glassboro, NJ 08028

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

402 Lippincott Dr
Marlton, NJ 08053
Phone (410) 763-8787

532 Marlton Pike W
Marlton, NJ 08053
Phone (856) 242-2121

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1510272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1013420298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E CHURCH ST",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080123910",
            "telephone_number": "856-227-6575",
            "fax_number": "856-374-9465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E CHURCH ST",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080123910",
            "telephone_number": "856-227-6575",
            "fax_number": "856-374-9465"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "532 OLD MARLTON PIKE W",
            "address_2": "PMB 510",
            "address_purpose": "LOCATION",
            "city": "EVESHAM",
            "state": "NJ",
            "postal_code": "080532075",
            "country_code": "US",
            "telephone_number": "856-242-2121",
            "fax_number": "856-249-3299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HASON",
        "first_name": "TATANISHA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-10",
        "last_updated": "2025-06-02",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00769500",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00769500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blackwood, NJ

Sources for this page

Verify at the official NPI Registry.