Individual provider Active NPI

Frank J. Stafford I, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Cherry Hill, NJ
National Provider Identifier
1073708236
Registry record updated May 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ00129900 Issued in NJ
Practice address
2250 Chapel Ave W
Cherry Hill
Cherry Hill, NJ 08002-2051
Phone
(856) 482-9000
Fax
(856) 482-1159
NPI assigned
Sep 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ00129900 NJ Primary

Addresses

Primary practice location

2250 Chapel Ave W
Cherry Hill
Cherry Hill, NJ 08002-2051

Mailing address

2250 Chapel Ave W
Suite 100
Cherry Hill, NJ 08002-2051
Phone (856) 482-9000

Other identifiers 2

IdentifierTypeStateIssuer
0177555MedicaidNJ
P00755957OtherNJRAILROAD MEDICARE

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
I20081101000008 NJ Practitioner - Nurse Practitioner 4385703636 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cumberland County Guidance CenterGroup PAC ID 0345280814, 7 clinicians

Practice addresses (Care Compare)

2038 Carmel Rd
Millville, NJ 08332-9754
Phone (856) 825-6810

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00129900NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Commons, Inc. CurrentSince Dec 7, 2015 Accepting new patients
Healthcare Commons, Inc. CurrentSince Dec 7, 2015 Accepting new patients
Healthcare Commons, Inc. Current Accepting new patients

Locations

500 S Pennsville Auburn Rd
Penns Grove, NJ 08069
Phone (856) 299-3200

Interoperability endpoints

  • Direct secure messaging: fstafford252956@directvirtua.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1073708236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 CHAPEL AVE W",
            "address_2": "SUITE 100",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080022051",
            "telephone_number": "856-482-9000",
            "fax_number": "856-482-1159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 CHAPEL AVE W",
            "address_2": "CHERRY HILL",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080022051",
            "telephone_number": "856-482-9000",
            "fax_number": "856-482-1159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "FRANK",
        "middle_name": "J.",
        "name_suffix": "I",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-11",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00129900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0177555",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00755957",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.