Individual provider Active NPI

Nancy C Whelan, RN,APN-C

  • Pediatric Nurse Practitioner
  • Newark, NJ
National Provider Identifier
1114124203
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
26NN10834400 Issued in NJ
Practice address
200 Lyons Ave
Building L-5 Pediatric Gastroenterology
Newark, NJ 07112-2026
Phone
(973) 926-7280
Fax
(973) 705-3148
NPI assigned
Jul 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 26NO10834400 NJ
Pediatric Nurse Practitioner 363LP0200X 26NN10834400 NJ Primary

Addresses

Primary practice location

200 Lyons Ave
Building L-5 Pediatric Gastroenterology
Newark, NJ 07112-2026

Mailing address

1123 Coolidge Rd
Elizabeth, NJ 07208-1005
Phone (908) 355-0355

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
I20130410000502 NJ Practitioner - Nurse Practitioner 6901042290 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NN10834400NJMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Scleroderma Program Current Accepting new patients
Rutgers Health-RWJ Scleroderma Program CurrentSince Sep 30, 2015 Accepting new patients
Rutgers Health-RWJ Primary Medicine Group Current Accepting new patients
Rutgers Health-RWJ Scleroderma Program CurrentSince Feb 1, 2021 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Feb 9, 2013 Accepting new patients
Rutgers Health-RWJ Scleroderma Program Current Accepting new patients
Barnabas Health Medical Group PC CurrentSince Feb 9, 2013 Accepting new patients

Locations

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

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

89 French St
New Brunswick, NJ 08901
Phone (732) 235-6230

195 Little Albany St
New Brunswick, NJ 08901
Phone (732) 235-2465

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

125 Paterson St
Ste 5100
New Brunswick, NJ 08901
Phone (732) 235-7060

125 Paterson St
Ste 6100
New Brunswick, NJ 08901
Phone (732) 235-6561

125 Paterson St
Ste 4200
New Brunswick, NJ 08901
Phone (732) 235-6600

Organizations & group practices 7

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": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1114124203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 COOLIDGE RD",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072081005",
            "telephone_number": "908-355-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LYONS AVE",
            "address_2": "BUILDING L-5 PEDIATRIC GASTROENTEROLOGY",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122026",
            "telephone_number": "973-926-7280",
            "fax_number": "973-705-3148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHELAN",
        "first_name": "NANCY",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "RN,APN-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NO10834400",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "26NN10834400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.