Active NPI
Ellen Vanderstad, APN
- Family Nurse Practitioner
- Montville, NJ
National Provider Identifier
1386012979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 26NJ00588600
- Practice address
- 137 Main Rd
Suite 200
Montville, NJ 07045-9231 - Phone
- (973) 402-0025
- Fax
- (973) 402-0508
- NPI assigned
- Sep 13, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 26NJ00588600 | NJ | Primary |
Addresses
Primary practice location
137 Main Rd
Suite 200
Montville, NJ 07045-9231
Mailing address
137 Main Rd
Ste 200
Montville, NJ 07045-9231
Phone (973) 703-0018
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462406400000",
"number": "1386012979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "137 MAIN RD",
"address_2": "STE 200",
"city": "MONTVILLE",
"state": "NJ",
"postal_code": "070459231",
"telephone_number": "973-703-0018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "137 MAIN RD",
"address_2": "SUITE 200",
"city": "MONTVILLE",
"state": "NJ",
"postal_code": "070459231",
"telephone_number": "973-402-0025",
"fax_number": "973-402-0508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDERSTAD",
"first_name": "ELLEN",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-13",
"last_updated": "2016-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NJ",
"license": "26NJ00588600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montville, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.