Individual provider Active NPI

Ermide C Ladouceur

  • Primary Care Nurse Practitioner
  • Union, NJ
National Provider Identifier
1174349658
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
26NJ15170100 Issued in NJ
Practice address
1018 Redspire Dr
Union, NJ 07083-5063
Phone
(908) 380-8994
NPI assigned
Nov 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 26NJ15170100 NJ Primary

Addresses

Primary practice location

1018 Redspire Dr
Union, NJ 07083-5063

Mailing address

1018 Redspire Dr
Union, NJ 07083-5063
Phone (908) 380-8994

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
I20250115003157 NJ Practitioner - Nurse Practitioner 7416485677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Personal NP Services LLCGroup PAC ID 9335455179, 65 clinicians

Practice addresses (Care Compare)

456 Chestnut St
Suite 102
Lakewood, NJ 08701-6124
Phone (732) 486-7373

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Personal NP Services, LLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

456 Chestnut St
Ste 102
Lakewood, NJ 08701
Phone (732) 282-7200

685 River Ave
Unit 3
Lakewood, NJ 08701
Phone (732) 987-3855

Organizations & group practices 1

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": "1732838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1174349658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 REDSPIRE DR",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835063",
            "telephone_number": "908-380-8994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 REDSPIRE DR",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835063",
            "telephone_number": "908-380-8994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADOUCEUR",
        "first_name": "ERMIDE",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-29",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ15170100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

Verify at the official NPI Registry.