Individual provider Active NPI

Elaine Gail Lange, R.N, A.P.N.

  • Adult Health Nurse Practitioner
  • Sicklerville, NJ
National Provider Identifier
1083694913
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
NN08298500 Issued in NJ
Practice address
485 Williamstown Rd
Sicklerville, NJ 08081-1777
Phone
(856) 227-6575
Fax
(856) 237-8042
NPI assigned
Jan 18, 2006
Last updated
Nov 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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 NN08298500 NJ Primary
Registered Nurse 163W00000X NO08298500 NJ

Addresses

Primary practice location

485 Williamstown Rd
Sicklerville, NJ 08081-1777

Mailing address

402 Lippincott Dr
Marlton, NJ 08053-4112
Phone (856) 782-3300

Other practice location 1

100 Bowman Dr Lowr Level1
Voorhees, NJ 08043-9612
Phone (856) 247-3000

Other identifiers 1

IdentifierTypeStateIssuer
0075337MedicaidNJ

Other names 1

  • Elaine Gail Erne Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address elange19122@directvirtua.org

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
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
NO08298500NJMDRegistered Nurse
NN08298500NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rowansom New Jersey Institute for Successful Aging Past Accepting new patients
Rowansom Newjersey Institute for Successful Aging-Geriatric Psychiatry Past Accepting new patients

Organizations & group practices 2

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": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1083694913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 LIPPINCOTT DR",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534112",
            "telephone_number": "856-782-3300",
            "fax_number": "856-504-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 WILLIAMSTOWN RD",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080811777",
            "telephone_number": "856-227-6575",
            "fax_number": "856-237-8042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Bowman Dr Lowr Level1",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080439612",
            "country_code": "US",
            "telephone_number": "856-247-3000",
            "fax_number": "856-247-2597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANGE",
        "first_name": "ELAINE",
        "middle_name": "GAIL",
        "name_prefix": "Mrs.",
        "credential": "R.N, A.P.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "NN08298500",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "NO08298500",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0075337",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elange19122@directvirtua.org",
            "affiliation": "N",
            "address_1": "100 Bowman Dr Lowr Level1",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELAINE",
            "last_name": "ERNE",
            "middle_name": "GAIL",
            "credential": "R.N, A.P.N.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sicklerville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.