Individual provider Active NPI

Marjorie A Chiavacci, CRNA

  • Certified Registered Nurse Anesthetist
  • Cherry Hill, NJ
National Provider Identifier
1306861935
Registry record updated Jan 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN286751L Issued in PA
Practice address
408 Route 70 East
Cherry Hill, NJ 08034
Phone
(215) 829-3867
Fax
(215) 829-5567
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN286751L PA Primary
Certified Registered Nurse Anesthetist 367500000X 26NR07942400 NJ

Addresses

Primary practice location

408 Route 70 East
Cherry Hill, NJ 08034

Mailing address

804 Scott Nixon Memorial Dr
Augusta, GA 30907-2464
Phone (800) 394-4445

Other identifiers 2

IdentifierTypeStateIssuer
P00614951OtherPARAILROAD MEDICARE
50077109OtherPACAPIITAL BLUE CROSS, KEYSTONE CENTRAL, SENIOR BLUE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041228000583 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5395703060 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Society Hill Anesthesia Consultants, PC CurrentSince Nov 19, 2018 Accepting new patients
Associates in Anesthesia, Inc. CurrentSince Mar 28, 2022 Accepting new patients
Ultracare Anesthesia Partners LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 25, 2019 Accepting new patients
Professional Anesthesia Services of North America P.C. Nurse Anesthetist, Certified Registered CurrentSince Jan 29, 2020 Accepting new patients
Society Hill Anesthesia Consultants of New Jersey, PC Past Accepting new patients
Rancocas Anesthesiology, P.a. Past Accepting new patients
Associates in Anesthesia Past Accepting new patients
Clinical Pain Management Associates, PC Past Accepting new patients

Locations

804 Scott Nixon Memorial Dr
Martinez, GA 30907

600 S White Horse Pike
Hammonton, NJ 08037
Phone (609) 561-6700

2310 Highland Ave
Bethlehem, PA 18020
Phone (610) 691-4300

1212 Baltimore Pike
Ste 200
Chadds Ford, PA 19317
Phone (610) 874-4147

30 Medical Center Blvd
Ste 305
Chester, PA 19013
Phone (610) 619-7411

501 N Lansdowne Ave
Drexel Hill, PA 19026
Phone (610) 284-8100

1800 Byberry Rd
Ste 1101
Huntingdon Vy, PA 19006
Phone (215) 947-7992

9500 Roosevelt Blvd
Philadelphia, PA 19115
Phone (215) 969-1048

3340 S Broad St
Philadelphia, PA 19145
Phone (215) 453-1900

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

100 E Lancaster Ave
Ste 158
Wynnewood, PA 19096
Phone (484) 206-5800

2752 Century Blvd
Wyomissing, PA 19610
Phone (610) 378-8800

1280 Broadcasting Rd
Wyomissing, PA 19610
Phone (215) 949-3100

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/0d26bd04-9128-4f58-8e6d-ffda5cd00f89/

Organizations & group practices 8

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641686400000",
    "number": "1306861935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SCOTT NIXON MEMORIAL DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309072464",
            "telephone_number": "800-394-4445",
            "fax_number": "706-434-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 ROUTE 70 EAST",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "08034",
            "telephone_number": "215-829-3867",
            "fax_number": "215-829-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIAVACCI",
        "first_name": "MARJORIE",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2022-01-09",
        "certification_date": "2022-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN286751L",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NR07942400",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00614951",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPIITAL BLUE CROSS, KEYSTONE CENTRAL, SENIOR BLUE",
            "identifier": "50077109",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.