Individual provider Active NPI

Dianna M Shinkarow, MSN, APRN, NP-C

  • Family Nurse Practitioner
  • Mount Laurel, NJ
National Provider Identifier
1033603949
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00828500 Issued in NJ
Practice address
100 Century Pkwy Ste 140
Mount Laurel, NJ 08054-1149
Phone
(856) 380-2400
Fax
(856) 234-7870
NPI assigned
Jun 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00828500 NJ Primary

Addresses

Primary practice location

100 Century Pkwy Ste 140
Mount Laurel, NJ 08054-1149

Mailing address

100 Century Pkwy Ste 140
Mount Laurel, NJ 08054-1149
Phone (856) 380-2400

Other practice location 1

1474 Tanyard Road
Suite D100
Sewell, NJ 08080
Phone (856) 566-6265

Other practice location 2

854 S White Horse Pike Unit 4
Hammonton, NJ 08037-2033
Phone (609) 704-0185

Other practice location 3

42 E Laurel Rd Ste 2100-A
Stratford, NJ 08084-1354
Phone (856) 566-7020

Other practice location 4

405 Hurffville Crosskeys Rd Ste 101
Sewell, NJ 08080-9340
Phone (856) 218-0300

Other identifiers 1

IdentifierTypeStateIssuer
0658766MedicaidNJ

Electronic endpoints 6

TypeEndpointUseAffiliation
Direct Messaging Address dshinkarow248962@directvirtua.org
Direct Messaging Address dshinkarow248962@directvirtua.org
Direct Messaging Address dshinkarow248962@directvirtua.org
Direct Messaging Address dshinkarow248962@directvirtua.org
Direct Messaging Address dshinkarow248962@directvirtua.org
Direct Messaging Address dshinkarow248962@directvirtua.org

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
I20181015001793 NJ Practitioner - Nurse Practitioner 8022360379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

100 Century Pkwy
Mount Laurel, NJ 08054-1149

3242 Route 206
Bordentown, NJ 08505-4517

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.15 of 100Reported as group
Quality
62.28
Promoting interoperability
100
Improvement activities
40
Cost
74.89

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00828500NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Jun 1, 2023 Accepting new patients
Virtua Medical Group, PA CurrentSince Jun 1, 2023 Accepting new patients
Kennedy University Hospital Inc. Past Accepting new patients
Rowansom Dept of Pediatrics Past Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

854 S White Horse Pike
Unit 4
Hammonton, NJ 08037
Phone (609) 704-0185

141 Route 70 E
Ste E
Marlton, NJ 08053
Phone (856) 985-7373

303 Lippincott Dr
Marlton, NJ 08053

100 Century Pkwy
Ste 140
Mount Laurel, NJ 08054
Phone (856) 380-2400

1474 Tanyard Rd
Ste D100
Sewell, NJ 08080
Phone (856) 566-6265

570 Egg Harbor Rd
Ste C2D
Sewell, NJ 08080
Phone (856) 218-0300

405 Hurffville Crosskeys Rd
Ste 101
Sewell, NJ 08080
Phone (856) 218-0300

42 E Laurel Rd
Ste 2100A
Stratford, NJ 08084
Phone (856) 566-6477

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1529020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1033603949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CENTURY PKWY STE 140",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541149",
            "telephone_number": "856-380-2400",
            "fax_number": "856-234-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CENTURY PKWY STE 140",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541149",
            "telephone_number": "856-380-2400",
            "fax_number": "856-234-7870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1474 Tanyard Road",
            "address_2": "Suite D100",
            "address_purpose": "LOCATION",
            "city": "Sewell",
            "state": "NJ",
            "postal_code": "08080",
            "country_code": "US",
            "telephone_number": "856-566-6265",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "854 S White Horse Pike Unit 4",
            "address_purpose": "LOCATION",
            "city": "Hammonton",
            "state": "NJ",
            "postal_code": "080372033",
            "country_code": "US",
            "telephone_number": "609-704-0185",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "42 E Laurel Rd Ste 2100-A",
            "address_purpose": "LOCATION",
            "city": "Stratford",
            "state": "NJ",
            "postal_code": "080841354",
            "country_code": "US",
            "telephone_number": "856-566-7020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 Hurffville Crosskeys Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Sewell",
            "state": "NJ",
            "postal_code": "080809340",
            "country_code": "US",
            "telephone_number": "856-218-0300",
            "fax_number": "856-589-5082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHINKAROW",
        "first_name": "DIANNA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-15",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00828500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0658766",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dshinkarow248962@directvirtua.org",
            "affiliation": "N",
            "address_1": "42 E Laurel Rd Ste 2100-A",
            "city": "Stratford",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080841354",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dshinkarow248962@directvirtua.org",
            "affiliation": "N",
            "address_1": "1474 Tanyard Road",
            "address_2": "Suite D100",
            "city": "Sewell",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "08080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dshinkarow248962@directvirtua.org",
            "affiliation": "N",
            "address_1": "100 Century Pkwy Ste 140",
            "city": "Mount Laurel",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080541149",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dshinkarow248962@directvirtua.org",
            "affiliation": "N",
            "address_1": "854 S White Horse Pike Unit 4",
            "city": "Hammonton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080372033",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dshinkarow248962@directvirtua.org",
            "affiliation": "N",
            "address_1": "570 Egg Harbor Rd Ste C2-D",
            "city": "Sewell",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080802359",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dshinkarow248962@directvirtua.org",
            "affiliation": "N",
            "address_1": "405 Hurffville Crosskeys Rd Ste 101",
            "city": "Sewell",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080809340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

Verify at the official NPI Registry.