Susan Amy Bergdoll-Faykes, MSN, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

26NN06050200 Issued in NJ

Practice address

693 Main St
Lumberton, NJ 08048-5043

Phone

(609) 261-4058

Fax

(609) 261-8381

NPI assigned

Jun 5, 2008

Last updated

Jun 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Certified Pediatric Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: susan.bergdollfaykes@advocaredoctors.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advocare, LLC

  • Pediatrics Physician
  • Marlton, NJ
  • NPI 1770538696
  Medicare reassignment NPD
• Advocare , LLC

  dba Advocare Berlin Medical Associates (DME)

  • Internal Medicine Physician
  • Manahawkin, NJ
  • NPI 1912762162
  NPD
• Advocare, LLC

  dba Advocare Ped. Physicians of Burlington Co.

  • Pediatrics Physician
  • Lumberton, NJ
  • NPI 1255343232
  NPD (past)
• Advocare, LLC

  dba Advocare Merchantville Pediatrics

  • Pediatrics Physician
  • Cherry Hill, NJ
  • NPI 1780696732
  NPD (past)

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1245499268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 PINE VALLEY RD",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342816",
            "telephone_number": "609-261-4058",
            "fax_number": "609-261-8381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "693 MAIN ST",
            "city": "LUMBERTON",
            "state": "NJ",
            "postal_code": "080485043",
            "telephone_number": "609-261-4058",
            "fax_number": "609-261-8381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGDOLL-FAYKES",
        "first_name": "SUSAN",
        "middle_name": "AMY",
        "name_prefix": "Mrs.",
        "credential": "MSN, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-05",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "26NN06050200",
            "primary": true
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "NJ",
            "license": "26NN06050200",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jennifer Lynn Beverly
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• Meredith M Bittner, LPC

• Pediatric Nurse Practitioner in Lumberton, NJ
• Providers in Lumberton, NJ by specialty
• Pediatric Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.