Individual provider Active NPI

Indira Michelle Chandler

  • Family Nurse Practitioner
  • Woodbury, NJ
National Provider Identifier
1124457247
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00470400 Issued in NJ
Practice address
1 Lupton Ave
Woodbury, NJ 08096-5901
Phone
(856) 537-5081
NPI assigned
Nov 8, 2013
Last updated
Nov 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00470400 NJ Primary

Addresses

Primary practice location

1 Lupton Ave
Woodbury, NJ 08096-5901

Mailing address

1 Lupton Ave
Woodbury, NJ 08096-5901

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
I20140203000311 NJ Practitioner - Nurse Practitioner 8426287996 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Princeton Healthcare Affiliated Physicians PC CurrentSince Mar 25, 2017 Accepting new patients
Princeton Healthcare Affiliated Physicians PC Current Accepting new patients
Family Therapy and Consultation Services CurrentSince Nov 1, 2024 Accepting new patients
Princeton Healthcare Affiliated Physicians PC CurrentSince Mar 25, 2017 Accepting new patients
Grow Healthcare Group of New Jersey PC CurrentSince Feb 20, 2025 Accepting new patients
United Family Services Past Accepting new patients

Locations

401 Ridge Rd
Ste 6
Dayton, NJ 08810
Phone (732) 329-4800

221 River St
Ste 9
Hoboken, NJ 07030
Phone (201) 439-8902

1 Lupton Ave
Woodbury, NJ 08096
Phone (856) 332-4698

131 Delaware St
Woodbury, NJ 08096
Phone (856) 537-5081

Organizations & group practices 6

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": "1383868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1124457247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LUPTON AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080965901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LUPTON AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080965901",
            "telephone_number": "856-537-5081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDLER",
        "first_name": "INDIRA",
        "middle_name": "MICHELLE",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-08",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00470400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NJ

Sources for this page

Verify at the official NPI Registry.