Individual provider Active NPI

Nicole Ricker, FNP-C

  • Nurse Practitioner
  • Hainesport, NJ
National Provider Identifier
1053087437
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ01178800 Issued in NJ
Practice address
404 Creek Crossing Blvd
Hainesport, NJ 08036-2768
Phone
(609) 845-3988
NPI assigned
Aug 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ01178800 NJ Primary

Addresses

Primary practice location

404 Creek Crossing Blvd
Hainesport, NJ 08036-2768

Mailing address

4101 Route 42
Blackwood, NJ 08012-1782
Phone (856) 516-4566

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
I20211005001221 NJ Practitioner - Nurse Practitioner 9436557501 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Care, Inc.Group PAC ID 9335040419, 126 clinicians
Pulse Vascular LLCGroup PAC ID 7618219361, 34 clinicians

Practice addresses (Care Compare)

335 Delsea Dr N
Glassboro, NJ 08028-1403
Phone 85645147002755

785 W Sherman Ave
Vineland, NJ 08360-6913
Phone (856) 451-4700

994 W Sherman Ave
BLDG 2
Vineland, NJ 08360-6937
Phone (631) 534-7846

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ01178800NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pulse Vascular, LLC CurrentSince Nov 2, 2023 Accepting new patients
Community Health Care, Inc. CurrentSince Sep 30, 2025 Accepting new patients
Community Health Care, Inc. CurrentSince Sep 30, 2025 Accepting new patients
Community Health Care, Inc. Past Accepting new patients

Locations

30 N Pearl St
Bridgeton, NJ 08302

715 Delsea Dr N
Glassboro, NJ 08028
Phone (856) 863-5720

335 Delsea Dr N
Glassboro, NJ 08028
Phone 85645147002755

530 High St N
Millville, NJ 08332
Phone (856) 506-8556

785 W Sherman Ave
Vineland, NJ 08360

994 W Sherman Ave
Bldg 2
Vineland, NJ 08360
Phone (631) 534-7246

Interoperability endpoints

  • Direct secure messaging: nicole.ricker.p1@direct.cchn.nextgenshare.com

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, 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": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1053087437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 ROUTE 42",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080121782",
            "telephone_number": "856-516-4566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 CREEK CROSSING BLVD",
            "city": "HAINESPORT",
            "state": "NJ",
            "postal_code": "080362768",
            "telephone_number": "609-845-3988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKER",
        "first_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-17",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ01178800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hainesport, NJ

Sources for this page

Verify at the official NPI Registry.