Individual provider Active NPI

Carlisa M Brown, AGACNP

  • Acute Care Nurse Practitioner
  • Camden, NJ
National Provider Identifier
1184256182
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
26NJ01020600 Issued in NJ
Practice address
1 Cooper PLZ
Camden, NJ 08103-1461
Phone
(856) 342-2000
NPI assigned
Feb 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 26NJ01020600 NJ Primary

Addresses

Primary practice location

1 Cooper PLZ
Camden, NJ 08103-1461

Mailing address

1 Federal St Ste 200
Camden, NJ 08103-1088
Phone (848) 288-6935

Other names 1

  • Carlisa M Gatlin Former name

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
I20210111000876 NJ Practitioner - Nurse Practitioner 4587091988 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cooper Surgical Associates, PAGroup PAC ID 3274430764, 303 clinicians

Practice addresses (Care Compare)

3 Cooper PLZ
Camden, NJ 08103-1438
Phone (856) 795-9330

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.23 of 100Reported as group
Quality
77.64
Promoting interoperability
98
Improvement activities
40
Cost
68.41

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ01020600NJMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Surgical Associates, PA CurrentSince Jun 29, 2022 Accepting new patients
Cooper Physician Offices, PA CurrentSince Jun 22, 2021 Accepting new patients
Cooper Surgical Associates, PA CurrentSince Jun 29, 2022 Accepting new patients

Locations

1 Federal St
Ste 200
Camden, NJ 08103
Phone (848) 288-6935

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

3 Cooper Plz
Rm 411
Camden, NJ 08103
Phone (856) 342-2270

3 Cooper Plz
Rm 104
Camden, NJ 08103
Phone (609) 963-6770

3 Cooper Plz
Fl 1
Camden, NJ 08103
Phone (856) 795-9330

3 Cooper Plz
Rm 403
Camden, NJ 08103
Phone (856) 342-2439

1210 Brace Rd
Cherry Hill, NJ 08034
Phone (609) 428-6616

127 Church Rd
Ste 400
Marlton, NJ 08053
Phone (856) 814-3000

2 Plaza Dr
Ste 202
Sewell, NJ 08080
Phone (856) 270-4100

6015 Main St
Voorhees, NJ 08043
Phone (856) 325-6516

2401 E Evesham Rd
Ste F
Voorhees, NJ 08043
Phone (856) 673-1600

218 Sunset Rd
Ste 1B
Willingboro, NJ 08046
Phone (215) 355-9634

66 East Ave
Fl 1
Woodstown, NJ 08098

Interoperability endpoints

  • Direct secure messaging: cbrown4453@direct.cooperhealth.edu

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1581033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1184256182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST STE 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "848-288-6935",
            "fax_number": "732-790-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461",
            "telephone_number": "856-342-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CARLISA",
        "middle_name": "M",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-07",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NJ01020600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLISA",
            "last_name": "GATLIN",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.