Individual provider Active NPI

Lauren Wynne, APN

  • Family Nurse Practitioner
  • Woodbury Heights, NJ
National Provider Identifier
1316614316
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ01168200 Issued in NJ
Practice address
1006 Mantua Pike
Woodbury Heights, NJ 08097-1221
Phone
(800) 789-7366
NPI assigned
Aug 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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 26NJ01168200 NJ Primary

Addresses

Primary practice location

1006 Mantua Pike
Woodbury Heights, NJ 08097-1221

Mailing address

15 S Bank St Apt 400
Philadelphia, PA 19106-2829
Phone (516) 851-9807

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
I20211012002111 NJ Practitioner - Nurse Practitioner 9931507597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinical Health Care Associates of New Jersey PCGroup PAC ID 0749180198, 793 clinicians

Practice addresses (Care Compare)

1006 Mantua Pike
Woodbury, NJ 08097-1221
Phone (856) 845-8600

Hospital & facility affiliations

  • Penn Presbyterian Medical Center Hospital, Philadelphia, PA, CCN 390223
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
  • Good Shepherd Penn Partners Long-term care hospital, Philadelphia, PA, CCN 392050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ01168200NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Health Care Associates of New Jersey PC CurrentSince Oct 24, 2021 Accepting new patients
Clinical Health Care Associates of New Jersey, P.C. CurrentSince Oct 24, 2021 Accepting new patients

Locations

1006 Mantua Pike
Spc Care
Woodbury, NJ 08097
Phone (856) 845-8600

1006 Mantua Pike
Woodbury Hts, NJ 08097
Phone (856) 845-6880

Organizations & group practices 2

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 4

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": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1316614316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 S BANK ST APT 400",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191062829",
            "telephone_number": "516-851-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 MANTUA PIKE",
            "city": "WOODBURY HEIGHTS",
            "state": "NJ",
            "postal_code": "080971221",
            "telephone_number": "800-789-7366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNNE",
        "first_name": "LAUREN",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01168200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury Heights, NJ

Sources for this page

Verify at the official NPI Registry.