Individual provider Active NPI

Prabha J Nair, M.D.

  • Pediatrics Physician
  • Bridgeton, NJ
National Provider Identifier
1174559207
Registry record updated Feb 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MA05991300 Issued in NJ
Practice address
70 Cohansey St
Bridgeton, NJ 08302-1918
Phone
(856) 451-4700
Fax
(856) 451-0029
NPI assigned
Jun 23, 2006
Last updated
Feb 24, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MA05991300 NJ Primary

Addresses

Primary practice location

70 Cohansey St
Bridgeton, NJ 08302-1918

Mailing address

53 S Laurel St
Second Floor
Bridgeton, NJ 08302-1946
Phone (856) 451-4700

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060201000455 NJ Practitioner - Pediatric Medicine 3072527084 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA05991300NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Care, Inc. CurrentSince May 14, 2009 Accepting new patients
Community Health Care, Inc. Pediatrics CurrentSince May 14, 2009 Accepting new patients
Community Health Care, Inc. Past Accepting new patients
Inspira Medical Centers, Inc. Past Accepting new patients

Locations

105 Manheim Ave
Bridgeton, NJ 08302
Phone (609) 451-4700

265 Irving Ave
Bridgeton, NJ 08302

30 N Pearl St
Bridgeton, NJ 08302

53 S Laurel St
#2
Bridgeton, NJ 08302

70 Cohansey St
Bridgeton, NJ 08302
Phone (856) 497-6650

410 Route 9 N
Cape May Court House, NJ 08210
Phone (609) 463-2151

335 Delsea Dr N
Glassboro, NJ 08028
Phone 85645147002755

319 W Landis Ave
Vineland, NJ 08360
Phone 8566913300 ext. 1167

785 W Sherman Ave
Vineland, NJ 08360

Interoperability endpoints

  • Direct secure messaging: prabha.nair.p1@direct.cchn.nextgenshare.com

Organizations & group practices 4

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330041600000",
    "number": "1174559207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 S LAUREL ST",
            "address_2": "SECOND FLOOR",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "083021946",
            "telephone_number": "856-451-4700",
            "fax_number": "856-863-5732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 COHANSEY ST",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "083021918",
            "telephone_number": "856-451-4700",
            "fax_number": "856-451-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIR",
        "first_name": "PRABHA",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2012-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "MA05991300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, NJ

Sources for this page

Verify at the official NPI Registry.