Individual provider Active NPI

Susan G Gominger, RN,MS,APNC

  • Obstetrics & Gynecology Nurse Practitioner
  • Paulsboro, NJ
National Provider Identifier
1215013198
Registry record updated Feb 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
26NN05354100 Issued in NJ
Practice address
600 Jessup Rd
Paulsboro, NJ 08066-2413
Phone
(845) 845-4061
Fax
(845) 384-1770
NPI assigned
Oct 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Perinatal Nurse Practitioner 363LP1700X 26NN05354100 NJ
Women's Health Nurse Practitioner 363LW0102X 26NN05354100 NJ
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 26NN05354100 NJ Primary

Addresses

Primary practice location

600 Jessup Rd
Paulsboro, NJ 08066-2413

Mailing address

600 Jessup Rd
Paulsboro, NJ 08066-2413
Phone (845) 845-4061

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
I20110106000416 NJ Practitioner - Nurse Practitioner 6901891225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Perelman School of Med at the University of Pennsylvania, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inspira Health Network Medical Group PCGroup PAC ID 4880797570, 238 clinicians

Practice addresses (Care Compare)

1450 Almonesson Rd
Suite 275
Deptford, NJ 08096-5243
Phone (856) 845-4061

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
26NN05354100NJMDPerinatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inspira Health Network Medical Group, P.C. CurrentSince Jan 1, 2016 Accepting new patients

Locations

1450 Almonesson Rd
Ste 275
Deptford, NJ 08096
Phone (856) 641-8680

698 Mullica Hill Rd
Ste 220
Mullica Hill, NJ 08062
Phone (856) 845-4061

798 Centerton Rd
Pittsgrove, NJ 08318
Phone (856) 358-6161

600 Jessup Rd
West Deptford, NJ 08086
Phone (856) 845-4061

800 Jessup Rd
Ste 809
West Deptford, NJ 08086
Phone (856) 845-4061

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.

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": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519084800000",
    "number": "1215013198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 JESSUP RD",
            "city": "PAULSBORO",
            "state": "NJ",
            "postal_code": "080662413",
            "telephone_number": "845-845-4061",
            "fax_number": "845-384-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 JESSUP RD",
            "city": "PAULSBORO",
            "state": "NJ",
            "postal_code": "080662413",
            "telephone_number": "845-845-4061",
            "fax_number": "845-384-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMINGER",
        "first_name": "SUSAN",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "RN,MS,APNC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2018-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP1700X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Perinatal",
            "state": "NJ",
            "license": "26NN05354100",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NJ",
            "license": "26NN05354100",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NJ",
            "license": "26NN05354100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paulsboro, NJ

Sources for this page

Verify at the official NPI Registry.