Individual provider Active NPI

Lauren Antonison, FNP-BC

  • Family Nurse Practitioner
  • West Deptford, NJ
National Provider Identifier
1235538091
Registry record updated May 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00515000 Issued in NJ
Practice address
213 Westwood CT
West Deptford, NJ 08096-3134
Phone
(856) 684-0326
NPI assigned
Aug 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00515000 NJ Primary

Addresses

Primary practice location

213 Westwood CT
West Deptford, NJ 08096-3134

Mailing address

1107 Mantua Pike Ste 720-208
Mantua, NJ 08051-1606
Phone (856) 684-0326

Other practice location 1

45 Euclid St Ste 202
Woodbury, NJ 08096-4631
Phone (856) 628-4504

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
I20141111000307 NJ Practitioner - Nurse Practitioner 8729200589 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jewish Federation of Southern NJGroup PAC ID 6103869466, 11 clinicians

Practice addresses (Care Compare)

West Deptford, NJ 08096
Phone (856) 684-0326

1107 Mantua Pike
Suite 720 208
Mantua, NJ 08051-1606

1301 Springdale Rd
Suite 150
Cherry Hill, NJ 08003-2763
Phone (856) 424-1333

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00515000NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Federation of Southern NJ CurrentSince Jul 25, 2023 Accepting new patients
Garden State Psychiatric Services, LLC Current Accepting new patients
Harmony Medical Services of New Jersey LLC CurrentSince Jun 1, 2023 Accepting new patients
Signify Health Medical Associates of New Jersey, LLC CurrentSince Jun 15, 2023 Accepting new patients
Lauren Antonison Wellness LLC Family CurrentSince Jan 3, 2023 Accepting new patients
Harmony Medical Services of New Jersey LLC CurrentSince Jun 1, 2023 Accepting new patients

Locations

6 E Miami Ave
Cherry Hill, NJ 08034
Phone (856) 428-1344

1301 Springdale Rd
Ste 150
Cherry Hill, NJ 08003
Phone (609) 424-1333

1107 Mantua Pike
Ste 720208
Mantua, NJ 08051

28 Valley Rd
Montclair, NJ 07042
Phone (908) 451-8519

116 Village Blvd
Ste 200
Princeton, NJ 08540
Phone (609) 285-3094

190 N Evergreen Ave
Ste 202
Woodbury, NJ 08096
Phone (856) 628-4504

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 7

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": "1408320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716076800000",
    "number": "1235538091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 MANTUA PIKE STE 720-208",
            "city": "MANTUA",
            "state": "NJ",
            "postal_code": "080511606",
            "telephone_number": "856-684-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 WESTWOOD CT",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "080963134",
            "telephone_number": "856-684-0326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45 Euclid St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "NJ",
            "postal_code": "080964631",
            "country_code": "US",
            "telephone_number": "856-628-4504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANTONISON",
        "first_name": "LAUREN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-18",
        "last_updated": "2024-05-19",
        "certification_date": "2024-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00515000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Deptford, NJ

Sources for this page

Verify at the official NPI Registry.