Active NPI
Jaclyn Shaffer
- Sports Medicine (Emergency Medicine) Physician
- Burlington, NJ
National Provider Identifier
1225545452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Emergency Medicine) Physician
- License
- NONE
- Practice address
- 67 Wellington PL
Burlington, NJ 08016-3329 - Phone
- (609) 670-1176
- Fax
- (609) 670-1176
- NPI assigned
- Jan 9, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Emergency Medicine) Physician | 207PS0010X | NONE | NJ | Primary |
Addresses
Primary practice location
67 Wellington PL
Burlington, NJ 08016-3329
Mailing address
67 Wellington PL
Burlington, NJ 08016-3329
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NONE | NJ | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515456000000",
"number": "1225545452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "67 WELLINGTON PL",
"city": "BURLINGTON",
"state": "NJ",
"postal_code": "080163329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "67 WELLINGTON PL",
"city": "BURLINGTON",
"state": "NJ",
"postal_code": "080163329",
"telephone_number": "609-670-1176",
"fax_number": "609-670-1176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFFER",
"first_name": "JACLYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-09",
"last_updated": "2018-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "207PS0010X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Sports Medicine",
"state": "NJ",
"license": "NONE",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burlington, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.