Phyllis McKiernan, RN, APN-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

26NJ00034600 Issued in NJ

Practice address

20 Prospect Ave Ste 400
Hackensack, NJ 07601-1941

Phone

(201) 996-5832

NPI assigned

May 10, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Regional Cancer Care Associates LLC

  • Hematology & Oncology Physician
  • Toms River, NJ
  • NPI 1801850243
  Medicare reassignment NPD
• Regional Cancer Care Associates LLC

  • Hematology & Oncology Physician
  • Belleville, NJ
  • NPI 1447315502
  NPD

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194939652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 MANNING RD",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076521800",
            "telephone_number": "201-251-6474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PROSPECT AVE STE 400",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011941",
            "telephone_number": "201-996-5832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKIERNAN",
        "first_name": "PHYLLIS",
        "name_prefix": "Mrs.",
        "credential": "RN, APN-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00034600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael McGuire, MD
• Maryrose McInerney, PH.D.
• Sean Aaron McKay, M.D.
• Laura Lorraine McKenna, NNP
• Alexa C McKeon, APN
• Mary Elizabeth McKiever
• Samantha Jayne McKinstry, MSN, FNP
• Alvin M McLaughlin, LSW, MDIV
• Kimberly L. McLaughlin, DPT
• Kyle McMahon, PA

• Adult Health Nurse Practitioner in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Adult Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.