Individual provider Active NPI

Abigail Collett Clark

  • Physician Assistant
  • Camden, NJ
National Provider Identifier
1376138289
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00684900 Issued in NJ
Practice address
1600 Haddon Ave FL 6
Camden, NJ 08103-3101
Phone
(856) 757-3500
Fax
(856) 365-4088
NPI assigned
Mar 2, 2021
Last updated
Dec 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 25MP00684900 NJ Primary

Addresses

Primary practice location

1600 Haddon Ave FL 6
Camden, NJ 08103-3101

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 757-3500

Other practice location 1

100 Bowman Dr Lowr Level1
Voorhees, NJ 08043-9612
Phone (856) 247-3000

Other practice location 2

218 Sunset Rd Fl 5
Willingboro, NJ 08046-1110
Phone (609) 444-0359

Other practice location 3

175 Madison Ave
Mount Holly, NJ 08060-2038
Phone (609) 914-6000

Other practice location 4

90 Brick Rd Fl 3
Marlton, NJ 08053-2177
Phone (856) 355-6000

Other names 1

  • Abigail Collett Stephens Former name

Electronic endpoints 5

TypeEndpointUseAffiliation
Direct Messaging Address aclark237215@directvirtua.org
Direct Messaging Address aclark237215@directvirtua.org
Direct Messaging Address aclark237215@directvirtua.org
Direct Messaging Address aclark237215@directvirtua.org
Direct Messaging Address aclark237215@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
I20221207002366 NJ Practitioner - Physician Assistant 7618346065 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family First Primary Physicians II LLCGroup PAC ID 1153778667, 7 clinicians
Plover Inpatient Services LLCGroup PAC ID 1355561663, 158 clinicians

Practice addresses (Care Compare)

1910 Hwy 35
Oakhurst, NJ 07755-2715
Phone (732) 531-4747

196 Jack Martin Blvd
Suite a 2
Brick, NJ 08724-7769
Phone (732) 458-4045

425 Jack Martin Blvd
Brick, NJ 08724-7732
Phone (732) 840-2200

Hospital & facility affiliations

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
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Plover Inpatient Services LLC Multi-Specialty CurrentSince Jan 1, 2026 Accepting new patients
Virtua Medical Group, PA CurrentSince Nov 28, 2022 Accepting new patients
Virtua Medical Group, PA Multi-Specialty CurrentSince Nov 28, 2022 Accepting new patients
Family First Primary Physicians LLC Past Accepting new patients
MVP Medical Associates, PA Multi-Specialty PastSince Sep 13, 2025 Accepting new patients
Virtua Medical Group, PA Multi-Specialty Past Accepting new patients

Locations

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

1600 Haddon Ave
Fl 6
Camden, NJ 08103
Phone (856) 247-2160

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

90 Brick Rd
Fl 3
Marlton, NJ 08053
Phone (856) 247-2160

175 Madison Ave
Mount Holly, NJ 08060
Phone (609) 261-1660

100 Bowman Dr
Lowr
Voorhees, NJ 08043
Phone (856) 247-3000

425 Jack Martin Blvd
Wall Township, NJ 08724
Phone (732) 840-2200

218 Sunset Rd
Fl 5
Willingboro, NJ 08046
Phone (609) 444-0359

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1614643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1376138289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LIPPINCOTT DR STE 410",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534197",
            "telephone_number": "856-757-3500",
            "fax_number": "856-365-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 HADDON AVE FL 6",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081033101",
            "telephone_number": "856-757-3500",
            "fax_number": "856-365-4088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Bowman Dr Lowr Level1",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080439612",
            "country_code": "US",
            "telephone_number": "856-247-3000",
            "fax_number": "856-247-2597",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "218 Sunset Rd Fl 5",
            "address_purpose": "LOCATION",
            "city": "Willingboro",
            "state": "NJ",
            "postal_code": "080461110",
            "country_code": "US",
            "telephone_number": "609-444-0359",
            "fax_number": "856-355-6731",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "175 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Mount Holly",
            "state": "NJ",
            "postal_code": "080602038",
            "country_code": "US",
            "telephone_number": "609-914-6000",
            "fax_number": "609-914-6182",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "90 Brick Rd Fl 3",
            "address_purpose": "LOCATION",
            "city": "Marlton",
            "state": "NJ",
            "postal_code": "080532177",
            "country_code": "US",
            "telephone_number": "856-355-6000",
            "fax_number": "856-355-6731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ABIGAIL",
        "middle_name": "COLLETT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-02",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00684900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aclark237215@directvirtua.org",
            "affiliation": "N",
            "address_1": "100 Bowman Dr Lowr Level1",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439612",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aclark237215@directvirtua.org",
            "affiliation": "N",
            "address_1": "175 Madison Ave",
            "city": "Mount Holly",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080602038",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aclark237215@directvirtua.org",
            "affiliation": "N",
            "address_1": "90 Brick Rd Fl 3",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080532177",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aclark237215@directvirtua.org",
            "affiliation": "N",
            "address_1": "218 Sunset Rd Fl 5",
            "city": "Willingboro",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080461110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aclark237215@directvirtua.org",
            "affiliation": "N",
            "address_1": "1600 Haddon Ave Fl 6",
            "city": "Camden",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "081033101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ABIGAIL",
            "last_name": "STEPHENS",
            "middle_name": "COLLETT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.