NPIMap

Organization Active NPI

Shonta D Collins Consulting Group LLC

  • Nurse Practitioner
  • Old Bridge, NJ
National Provider Identifier
1144797416
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
SHONTA D COLLINS CONSULTING GROUP LLC
Practice address
28 Throckmorton LN Ste 204
Old Bridge, NJ 08857-2558
Phone
(732) 952-3999
Fax
(732) 952-8989
NPI assigned
Oct 25, 2018
Last updated
Jul 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Authorized official

Name
Shonta Denise Collins, APNNPI 1689005589
Title
Sole Member
Phone
(215) 219-9588

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU Primary

Addresses

Primary practice location

28 Throckmorton LN Ste 204
Old Bridge, NJ 08857-2558

Mailing address

175 W Cohawkin Rd Ste C
Clarksboro, NJ 08020-1145
Phone (856) 423-7700

Other practice location 1

455 Hurffville Crosskeys Rd
Sewell, NJ 08080-2328
Phone (856) 512-0800

Other practice location 2

260 Terrace Dr
Blakely, PA 18447-2500
Phone (732) 952-3998

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20181126000867 NJ Part B Supplier - Clinic/Group Practice 0840544151 Receives reassigned benefits from 2 practitioners
Practice locations: Old Bridge, NJ; Sewell, NJ
O20220706000010 PA Part B Supplier - Clinic/Group Practice 0840544151 Receives reassigned benefits from 1 practitioner
Practice locations: Olyphant, PA

National Provider Directory

National Provider Directory

Locations

42 Throckmorton Ln
#211A
Old Bridge, NJ 08857
Phone (732) 679-1111

42 Throckmorton Ln
Ste 211A
Old Bridge, NJ 08857
Phone (732) 952-3999

455 Hurffville Crosskeys Rd
#R
Sewell, NJ 08080
Phone (856) 512-0800

260 Terrace Dr
Blakely, PA 18447
Phone (732) 952-3998

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656979200000",
    "number": "1144797416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 W COHAWKIN RD STE C",
            "city": "CLARKSBORO",
            "state": "NJ",
            "postal_code": "080201145",
            "telephone_number": "856-423-7700",
            "fax_number": "856-423-0823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 THROCKMORTON LN STE 204",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572558",
            "telephone_number": "732-952-3999",
            "fax_number": "732-952-8989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 Hurffville Crosskeys Rd",
            "address_purpose": "LOCATION",
            "city": "Sewell",
            "state": "NJ",
            "postal_code": "080802328",
            "country_code": "US",
            "telephone_number": "856-512-0800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "260 Terrace Dr",
            "address_purpose": "LOCATION",
            "city": "Blakely",
            "state": "PA",
            "postal_code": "184472500",
            "country_code": "US",
            "telephone_number": "732-952-3998",
            "fax_number": "732-952-8989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHONTA D COLLINS CONSULTING GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-25",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "SHONTA",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "215-219-9588",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Bridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.