Individual provider Active NPI

Debra Lynn Shearer, ED.D, MSN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Swedesboro, NJ
National Provider Identifier
1124356415
Registry record updated Jun 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ00795800 Issued in NJ
Practice address
1630 Route 322 Unit E
Swedesboro, NJ 08085-3701
Phone
(856) 418-0808
NPI assigned
Nov 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2022

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 26NJ00795800 NJ Primary

Addresses

Primary practice location

1630 Route 322 Unit E
Swedesboro, NJ 08085-3701

Mailing address

1630 Route 322 Unit E
Swedesboro, NJ 08085-3701
Phone (856) 418-0808

Other names 1

  • Debra Lynn Connolly Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100209000732 PA Practitioner - Nurse Practitioner 0345383550 Reassigns benefits to 1 organization
I20180515000048 NJ Practitioner - Nurse Practitioner 0345383550 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00795800NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shearer Mental Health and Wellness, LLC Psychiatric/Mental Health CurrentSince Jun 21, 2022 Accepting new patients
Meditelecare of Pennsylvania LLC Nurse Practitioner CurrentSince May 1, 2021 Accepting new patients
Clarity Psychiatric Care Psychiatric/Mental Health CurrentSince Jan 1, 2022 Accepting new patients
Atlantic Physician Services of Maryland, P.C. Nurse Practitioner Past Accepting new patients
Atlantic Physician Services of Maryland, PC Past Accepting new patients

Locations

2 Split Rock Dr
Ste 11
Cherry Hill, NJ 08003
Phone (856) 428-1260

1630 Route 322
Unit E
Woolwich Twp, NJ 08085
Phone (856) 418-0808

600 N 2nd St
Ste 401
Harrisburg, PA 17101
Phone (844) 341-2339

Organizations & group practices 5

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": "1259020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1124356415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 ROUTE 322 UNIT E",
            "city": "SWEDESBORO",
            "state": "NJ",
            "postal_code": "080853701",
            "telephone_number": "856-418-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 ROUTE 322 UNIT E",
            "city": "SWEDESBORO",
            "state": "NJ",
            "postal_code": "080853701",
            "telephone_number": "856-418-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEARER",
        "first_name": "DEBRA",
        "middle_name": "LYNN",
        "credential": "ED.D, MSN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-24",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00795800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "CONNOLLY",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Swedesboro, NJ

Sources for this page

Verify at the official NPI Registry.