Individual provider Active NPI

Phyllis A McGehean, CRNA

  • Certified Registered Nurse Anesthetist
  • Camden, NJ
National Provider Identifier
1073667796
Registry record updated Apr 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NR36968 Issued in NJ
Practice address
1 Cooper PLZ
Camden, NJ 08103-1461
Phone
(856) 342-2919
Fax
(856) 968-8239
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NR36968 NJ Primary

Addresses

Primary practice location

1 Cooper PLZ
Camden, NJ 08103-1461

Mailing address

3 Executive Campus FL 2
Route 70 Cuthbert Blvd
Cherry Hill, NJ 08002-4103
Phone (856) 356-5935

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
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
NR36968NJMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461542400000",
    "number": "1073667796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 EXECUTIVE CAMPUS FL 2",
            "address_2": "ROUTE 70 CUTHBERT BLVD",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080024103",
            "telephone_number": "856-356-5935",
            "fax_number": "856-356-4879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461",
            "telephone_number": "856-342-2919",
            "fax_number": "856-968-8239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGEHEAN",
        "first_name": "PHYLLIS",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2016-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "NR36968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.