Individual provider Active NPI

Laverne Graves-Washington, FNP-C

  • Family Nurse Practitioner
  • Pleasantville, NJ
National Provider Identifier
1174833495
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00771900 Issued in NJ
Practice address
268 North New Rd.
Pleasantville, NJ 08232
Phone
(609) 646-4064
Fax
(609) 272-8526
NPI assigned
Oct 20, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered Nurse 163WW0000X 26NO11508100 NJ
Family Medicine Physician 207Q00000X 26NJ00771900 NJ
Family Nurse Practitioner 363LF0000X 26NJ00771900 NJ Primary

Addresses

Primary practice location

268 North New Rd.
Pleasantville, NJ 08232

Mailing address

604 W. Adams Ave.
Pleasantville, NJ 08232-1503
Phone (609) 674-1651

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
I20180214001129 NJ Practitioner - Nurse Practitioner 9537429485 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NO11508100NJMDWound Care Registered Nurse
26NJ00771900NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Insightful Pathways LLC CurrentSince Oct 27, 2024 Accepting new patients
Smithville Medical Associates LLC Family Medicine CurrentSince Sep 11, 2024 Accepting new patients

Locations

28 S New York Rd
Ste C4
Galloway, NJ 08205
Phone (609) 652-0555

Organizations & group practices 2

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": "1287532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1174833495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 W. ADAMS AVE.",
            "city": "PLEASANTVILLE",
            "state": "NJ",
            "postal_code": "082321503",
            "telephone_number": "609-674-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 NORTH NEW RD.",
            "city": "PLEASANTVILLE",
            "state": "NJ",
            "postal_code": "08232",
            "telephone_number": "609-646-4064",
            "fax_number": "609-272-8526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES-WASHINGTON",
        "first_name": "LAVERNE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-20",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "NJ",
            "license": "26NO11508100",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "26NJ00771900",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00771900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasantville, NJ

Sources for this page

Verify at the official NPI Registry.