Individual provider Active NPI

Jean M McDermott, CRNP

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1235337064
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00176700 Issued in NJ
Practice address
3400 Spruce St
Ravdin 2ND FL
Philadelphia, PA 19104-4238
Phone
(215) 662-2354
NPI assigned
Jul 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00176700 NJ Primary
Family Nurse Practitioner 363LF0000X SP009363 PA

Addresses

Primary practice location

3400 Spruce St
Ravdin 2ND FL
Philadelphia, PA 19104-4238

Mailing address

3400 Spruce St
Ravdin 2ND FL
Philadelphia, PA 19104-4238
Phone (215) 662-2354

Other practice location 1

158 Route 73 Ste B
Voorhees, NJ 08043-9539
Phone (856) 247-7230

Other practice location 2

315 Route 70 E
Cherry Hill, NJ 08034-2408
Phone (856) 375-6240

Other practice location 3

128 Route 70 Ste 1
Medford, NJ 08055-2371
Phone (609) 367-0900

Other practice location 4

555 High St Ste 16A
Mount Holly, NJ 08060-1084
Phone (609) 444-5610

Other practice location 5

239 Hurffville Crosskeys Rd Ste 160
Sewell, NJ 08080-4005
Phone (856) 341-8200

Other practice location 6

602 W Cuthbert Blvd Unit 26
Haddon Township, NJ 08108-3642
Phone (856) 946-5180

Other practice location 7

141 Bridgeton Pike Unit B
Mullica Hill, NJ 08062-2615
Phone (856) 746-0206

Other practice location 8

401 Young Ave Ste 180 Front
Moorestown, NJ 08057-3139
Phone (856) 291-8600

Other identifiers 1

IdentifierTypeStateIssuer
0251224MedicaidNJ

Electronic endpoints 8

TypeEndpointUseAffiliation
Direct Messaging Address jmcdermott253119@directvirtua.org
Direct Messaging Address jmcdermott253119@directvirtua.org
Direct Messaging Address jmcdermott253119@directvirtua.org
Direct Messaging Address jmcdermott253119@directvirtua.org
Direct Messaging Address jmcdermott253119@directvirtua.org
Direct Messaging Address jmcdermott253119@directvirtua.org
Direct Messaging Address jmcdermott253119@directvirtua.org
Direct Messaging Address jmcdermott253119@directvirtua.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20071012000524 PA Practitioner - Nurse Practitioner 0547356198 Reassigns benefits to 1 organization
I20100225000554 NJ Practitioner - Nurse Practitioner 0547356198 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

239 Hurffville Crosskeys Rd
Suite 160
Sewell, NJ 08080-4005
Phone (856) 341-8200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00176700NJMDFamily Nurse Practitioner
SP009363PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Surgical Associates, PA CurrentSince Aug 25, 2014 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Aug 15, 2016 Accepting new patients
Cooper University Trauma Physicians, PC CurrentSince Aug 25, 2014 Accepting new patients
Cooper Surgical Associates, PA CurrentSince Aug 25, 2014 Accepting new patients
Minuteclinic Diagnostic of New Jersey LLC Family CurrentSince Dec 8, 2009 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Aug 15, 2016 Accepting new patients
Haddon Emergency Physicians LLC CurrentSince Jan 15, 2011 Accepting new patients
Virtua Medical Group, PA Current Accepting new patients
Virtua Medical Group, PA CurrentSince Nov 5, 2012 Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

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

1600 Haddon Ave
Camden, NJ 08103
Phone (609) 757-3500

1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920

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

315 Route 70 E
Cherry Hill, NJ 08034
Phone (856) 375-6240

602 W Cuthbert Blvd
Unit 26
Haddon Township, NJ 08108
Phone (856) 946-5180

4 Ryan Rd
Marlboro, NJ 07746
Phone (732) 431-8700

303 Lippincott Dr
Marlton, NJ 08053

128 Route 70
Ste 1
Medford, NJ 08055
Phone (609) 367-0900

401 Young Ave
Ste 180
Moorestown, NJ 08057
Phone (856) 291-8600

555 High St
Ste 16A
Mount Holly, NJ 08060
Phone (609) 444-5610

141 Bridgeton Pike
Unit B
Mullica Hill, NJ 08062
Phone (856) 746-0206

239 Hurffville Crosskeys Rd
Ste 160
Sewell, NJ 08080
Phone (856) 341-8200

158 Route 73
#B
Voorhees, NJ 08043
Phone (856) 247-7230

3400 Spruce St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-2428

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 9

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": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1235337064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "RAVDIN 2ND FL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-662-2354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "RAVDIN 2ND FL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-662-2354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "158 Route 73 Ste B",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080439539",
            "country_code": "US",
            "telephone_number": "856-247-7230",
            "fax_number": "856-247-7231",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 Route 70 E",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080342408",
            "country_code": "US",
            "telephone_number": "856-375-6240",
            "fax_number": "856-375-6241",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "128 Route 70 Ste 1",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "NJ",
            "postal_code": "080552371",
            "country_code": "US",
            "telephone_number": "609-367-0900",
            "fax_number": "609-367-0901",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "555 High St Ste 16A",
            "address_purpose": "LOCATION",
            "city": "Mount Holly",
            "state": "NJ",
            "postal_code": "080601084",
            "country_code": "US",
            "telephone_number": "609-444-5610",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "239 Hurffville Crosskeys Rd Ste 160",
            "address_purpose": "LOCATION",
            "city": "Sewell",
            "state": "NJ",
            "postal_code": "080804005",
            "country_code": "US",
            "telephone_number": "856-341-8200",
            "fax_number": "856-341-8215",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "602 W Cuthbert Blvd Unit 26",
            "address_purpose": "LOCATION",
            "city": "Haddon Township",
            "state": "NJ",
            "postal_code": "081083642",
            "country_code": "US",
            "telephone_number": "856-946-5180",
            "fax_number": "856-946-5181",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "141 Bridgeton Pike Unit B",
            "address_purpose": "LOCATION",
            "city": "Mullica Hill",
            "state": "NJ",
            "postal_code": "080622615",
            "country_code": "US",
            "telephone_number": "856-746-0206",
            "fax_number": "856-746-0207",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 Young Ave Ste 180 Front",
            "address_purpose": "LOCATION",
            "city": "Moorestown",
            "state": "NJ",
            "postal_code": "080573139",
            "country_code": "US",
            "telephone_number": "856-291-8600",
            "fax_number": "856-291-8610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDERMOTT",
        "first_name": "JEAN",
        "middle_name": "M",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00176700",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP009363",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0251224",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmcdermott253119@directvirtua.org",
            "affiliation": "N",
            "address_1": "141 Bridgeton Pike Unit B",
            "city": "Mullica Hill",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080622615",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmcdermott253119@directvirtua.org",
            "affiliation": "N",
            "address_1": "239 Hurffville Crosskeys Rd Ste 160",
            "city": "Sewell",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080804005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmcdermott253119@directvirtua.org",
            "affiliation": "N",
            "address_1": "158 Route 73 Ste B",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439539",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmcdermott253119@directvirtua.org",
            "affiliation": "N",
            "address_1": "555 High St Ste 16A",
            "city": "Mount Holly",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080601084",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmcdermott253119@directvirtua.org",
            "affiliation": "N",
            "address_1": "401 Young Ave Ste 180",
            "city": "Moorestown",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080573139",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmcdermott253119@directvirtua.org",
            "affiliation": "N",
            "address_1": "128 Route 70 Ste 1",
            "city": "Medford",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080552371",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmcdermott253119@directvirtua.org",
            "affiliation": "N",
            "address_1": "315 Route 70 E",
            "city": "Cherry Hill",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080342408",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmcdermott253119@directvirtua.org",
            "affiliation": "N",
            "address_1": "602 W Cuthbert Blvd Unit 26",
            "city": "Haddon Township",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "081083642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.