Ellen T Van Fossen, RN, APN

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

NN08244100 Issued in NJ

Practice address

42 Laurel Rd E
Udp #1800
Stratford, NJ 08084-1354

Phone

(856) 566-6843

Fax

(856) 566-6419

NPI assigned

Jan 19, 2006

Last updated

Jan 6, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Ellen T Doddy Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

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.

• Rowansom Dept of Obstetrics Gynecology

  • Obstetrics & Gynecology Physician
  • Stratford, NJ
  • NPI 1891765053
  NPD (past)

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452038400000",
    "number": "1093795585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 E LAUREL RD",
            "address_2": "UDP #1800",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841354",
            "telephone_number": "856-566-6843",
            "fax_number": "856-566-6419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 LAUREL RD E",
            "address_2": "UDP #1800",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841354",
            "telephone_number": "856-566-6843",
            "fax_number": "856-566-6419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN FOSSEN",
        "first_name": "ELLEN",
        "middle_name": "T",
        "credential": "RN, APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2016-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "NN08244100",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "NO08244100",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8132208",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "DODDY",
            "middle_name": "T",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Umdnj-Som
• Umdnjsom
• Ibrahim M Umer
• Rohan Umrani, DO
• Urocare of NJ P.a.
• Aayush Vashistha
• Andrew Vasta, D.O.
• Ivette Susana Velez, MS
• Lydia A. Vender, D.O.
• Thuc Kien Vu, DO

• Gerontology Nurse Practitioner in Stratford, NJ
• Providers in Stratford, NJ by specialty
• Gerontology Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.