Active NPI
Earle Bruce Myers, D.P.M.
- Podiatrist
- Hainesport, NJ
National Provider Identifier
1023063799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 25MD00185200
- Practice address
- 309 Creek Crossing Blvd
Hainesport, NJ 08036-2767 - Phone
- (609) 261-9660
- NPI assigned
- May 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 25MD00185200 | NJ | Primary |
Addresses
Primary practice location
309 Creek Crossing Blvd
Hainesport, NJ 08036-2767
Mailing address
309 Creek Crossing Blvd
Hainesport, NJ 08036-2767
Phone (609) 261-9660
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3682102 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1852 | NJ | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fusfield Podiatry Associates LLC | Podiatrist | Past | Accepting new patients |
| David & Gilbert D P M P a | Podiatrist | Past | Accepting new patients |
| New Jersey Podiatric Physicians & Surgeons Group, LLC | Podiatrist | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Podiatrist
- West Deptford, NJ
- NPI 1760545644
-
- Podiatrist
- Mount Holly, NJ
- NPI 1588618722
-
- Podiatrist
- Warren, NJ
- NPI 1326867540
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402272000000",
"number": "1023063799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "309 CREEK CROSSING BLVD",
"city": "HAINESPORT",
"state": "NJ",
"postal_code": "080362767",
"telephone_number": "609-261-9660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 CREEK CROSSING BLVD",
"city": "HAINESPORT",
"state": "NJ",
"postal_code": "080362767",
"telephone_number": "609-261-9660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYERS",
"first_name": "EARLE",
"middle_name": "BRUCE",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-23",
"last_updated": "2014-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NJ",
"license": "25MD00185200",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3682102",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hainesport, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.