Individual provider Active NPI

Grace A Flynn, APN

  • Gerontology Nurse Practitioner
  • Sewell, NJ
National Provider Identifier
1255857694
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
26NJ00723400 Issued in NJ
Practice address
1474 Tanyard Road
Suite C100
Sewell, NJ 08080
Phone
(856) 932-7476
Fax
(856) 566-6320
NPI assigned
Aug 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ00723400 NJ
Gerontology Nurse Practitioner 363LG0600X 26NJ00723400 NJ Primary

Addresses

Primary practice location

1474 Tanyard Road
Suite C100
Sewell, NJ 08080

Mailing address

1474 Tanyard Road
Suite C100
Sewell, NJ 08080-1573
Phone (856) 932-7476

Other practice location 1

3322 College Dr Ste C100
Vineland, NJ 08360-6926
Phone (856) 566-6406

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address gflynn280170@directvirtua.org
Direct Messaging Address gflynn280170@directvirtua.org

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
I20170925000376 NJ Practitioner - Nurse Practitioner 4789958174 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

1474 Tanyard Rd
Sewell, NJ 08080-4222

3242 Route 206
Bordentown, NJ 08505-4517

Hospital & facility affiliations

  • West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022
  • Virtua Our Lady of Lourdes Hospital Hospital, Camden, NJ, CCN 310029

Merit-based Incentive Payment System (MIPS)

Final score
81.15 of 100Reported as group
Quality
62.28
Promoting interoperability
100
Improvement activities
40
Cost
74.89

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA Current Accepting new patients
Virtua Medical Group, PA Nurse Practitioner CurrentSince Jul 1, 2024 Accepting new patients
Advanced Cardiology of South Jersey CurrentSince Oct 9, 2017 Accepting new patients
Virtua Medical Group, PA CurrentSince Jul 1, 2024 Accepting new patients
Custom Sleep Therapies PC PastSince Oct 9, 2017 Accepting new patients

Locations

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

141 Route 70 E
Ste E
Marlton, NJ 08053
Phone (856) 985-7373

303 Lippincott Dr
Marlton, NJ 08053

4 Burton Ln
Ste 100
Mullica Hill, NJ 08062
Phone (856) 241-3838

1474 Tanyard Rd
Ste C100
Sewell, NJ 08080
Phone (855) 932-7476

3322 College Dr
Ste C100
Vineland, NJ 08360
Phone (855) 932-7476

218 Sunset Rd
Willingboro, NJ 08046
Phone (609) 835-2900

Interoperability endpoints

  • Direct secure messaging: gflynn280170@directvirtua.org

Organizations & group practices 5

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 2

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": "1502928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1255857694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1474 TANYARD ROAD",
            "address_2": "SUITE C100",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080801573",
            "telephone_number": "856-932-7476",
            "fax_number": "856-566-6320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1474 TANYARD ROAD",
            "address_2": "SUITE C100",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "08080",
            "telephone_number": "856-932-7476",
            "fax_number": "856-566-6320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3322 College Dr Ste C100",
            "address_purpose": "LOCATION",
            "city": "Vineland",
            "state": "NJ",
            "postal_code": "083606926",
            "country_code": "US",
            "telephone_number": "856-566-6406",
            "fax_number": "856-566-6320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "GRACE",
        "middle_name": "A",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-17",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00723400",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00723400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gflynn280170@directvirtua.org",
            "affiliation": "N",
            "address_1": "1474 Tanyard Road",
            "address_2": "Suite C100",
            "city": "Sewell",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "08080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gflynn280170@directvirtua.org",
            "affiliation": "N",
            "address_1": "3322 College Dr Ste C100",
            "city": "Vineland",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "083606926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sewell, NJ

Sources for this page

Verify at the official NPI Registry.