Individual provider Active NPI

Nancy E Sudol, ANPC

  • Adult Health Nurse Practitioner
  • Galloway, NJ
National Provider Identifier
1306054978
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
Practice address
408 E Jimmie Leeds Rd
Galloway, NJ 08205-9706
Phone
(609) 652-6947
Fax
(609) 748-9075
NPI assigned
May 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X NJ Primary

Addresses

Primary practice location

408 E Jimmie Leeds Rd
Galloway, NJ 08205-9706

Mailing address

607 Pineview Dr
Galloway, NJ 08205-6012
Phone (609) 748-2760

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
I20120629000454 NJ Practitioner - Nurse Practitioner 9537324389 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MAO4844100NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey Cuidado Casero Hospice LLC CurrentSince Nov 1, 2024 Accepting new patients
Atlanticare Physician Group, PA CurrentSince Jul 6, 2019 Accepting new patients
Atlanticare Health Services, Inc. CurrentSince Mar 3, 2019 Accepting new patients
Atlanticare Physician Group PA CurrentSince Jul 6, 2019 Accepting new patients
Atlanticare Health Services, Inc. CurrentSince Mar 3, 2019 Accepting new patients
Atlanticare Health Services Inc. Past Accepting new patients

Locations

1401 Atlantic Ave
Ste 2100
Atlantic City, NJ 08401
Phone (609) 457-6489

1401 Atlantic Ave
Ste 2600
Atlantic City, NJ 08401
Phone (609) 441-8036

1401 Atlantic Ave
Ste 2500
Atlantic City, NJ 08401
Phone (609) 347-0052

2500 English Creek Ave
Ste 1002
Egg Harbor Township, NJ 08234
Phone (609) 407-2310

54 W Jimmie Leeds Rd
Ste 8
Galloway, NJ 08205
Phone (609) 404-7300

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

415 W Landis Ave
Ste 100
Vineland, NJ 08360
Phone (856) 696-5340

Organizations & group practices 6

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": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306054978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 PINEVIEW DR",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082056012",
            "telephone_number": "609-748-2760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 E JIMMIE LEEDS RD",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059706",
            "telephone_number": "609-652-6947",
            "fax_number": "609-748-9075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDOL",
        "first_name": "NANCY",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "ANPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galloway, NJ

Sources for this page

Verify at the official NPI Registry.