Active NPI
Craig W. Dingle
- Peer Specialist
- Bridgeton, NJ
National Provider Identifier
1174197149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- 2000324
- Practice address
- 70 W Broad St
Bridgeton, NJ 08302-2421 - Phone
- (856) 451-3727
- Fax
- (856) 455-9706
- NPI assigned
- May 14, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 2000324 | NJ | Primary |
Addresses
Primary practice location
70 W Broad St
Bridgeton, NJ 08302-2421
Mailing address
70 W Broad St
Bridgeton, NJ 08302-2421
Phone (856) 451-3727
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 031164 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2000324 | NJ | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620950400000",
"number": "1174197149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "70 W BROAD ST",
"city": "BRIDGETON",
"state": "NJ",
"postal_code": "083022421",
"telephone_number": "856-451-3727",
"fax_number": "856-455-9706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70 W BROAD ST",
"city": "BRIDGETON",
"state": "NJ",
"postal_code": "083022421",
"telephone_number": "856-451-3727",
"fax_number": "856-455-9706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DINGLE",
"first_name": "CRAIG",
"middle_name": "W.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-14",
"last_updated": "2021-05-14",
"certification_date": "2021-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "NJ",
"license": "2000324",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "031164",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bridgeton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.