Individual provider Active NPI

Patricia Ann Shorrock, RN,APN,C

  • Primary Care Nurse Practitioner
  • West Orange, NJ
National Provider Identifier
1053355768
Registry record updated Oct 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
26NO08114600 Issued in NJ
Practice address
101 Old Short Hills Rd
Suite 211
West Orange, NJ 07052-1000
Phone
(973) 736-4430
Fax
(973) 736-3733
NPI assigned
Jun 15, 2006
Last updated
Oct 7, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X NN81146 NJ
Primary Care Nurse Practitioner 363LP2300X 26NO08114600 NJ Primary

Addresses

Primary practice location

101 Old Short Hills Rd
Suite 211
West Orange, NJ 07052-1000

Mailing address

1801 Springbrook CT
Whippany, NJ 07981-1428
Phone (973) 739-9187

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
I20070111000563 NJ Practitioner - Nurse Practitioner 1456351626 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NN81146NJMDAdult Health Nurse Practitioner
26NO08114600NJMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA CurrentSince Oct 21, 2019 Accepting new patients
Summit Medical Group PA CurrentSince Oct 21, 2019 Accepting new patients
Internal Medicine Faculty Practice Associates at St Barnabas Med Ctr Past Accepting new patients
Summit Medical Group, Inc Past Accepting new patients

Locations

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

Interoperability endpoints

  • Direct secure messaging: patricia.shorrock.1@2983.direct.athenahealth.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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1053355768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 SPRINGBROOK CT",
            "city": "WHIPPANY",
            "state": "NJ",
            "postal_code": "079811428",
            "telephone_number": "973-739-9187",
            "fax_number": "973-736-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 OLD SHORT HILLS RD",
            "address_2": "SUITE 211",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521000",
            "telephone_number": "973-736-4430",
            "fax_number": "973-736-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORROCK",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "credential": "RN,APN,C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "NN81146",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NO08114600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

Verify at the official NPI Registry.