Individual provider Active NPI

Elizabeth M Dyer, NP-C

  • Family Nurse Practitioner
  • Hammonton, NJ
National Provider Identifier
1396339107
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ01099400 Issued in NJ
Practice address
600 S White Horse Pike
Hammonton, NJ 08037-2014
Phone
(609) 270-4260
NPI assigned
Feb 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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 26NJ01099400 NJ Primary

Addresses

Primary practice location

600 S White Horse Pike
Hammonton, NJ 08037-2014

Mailing address

112 Janet St
Vineland, NJ 08360-9616
Phone (609) 364-4937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210429001669 NJ Practitioner - Nurse Practitioner 4789093923 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Excelcare Alliance, LLC CurrentSince Apr 27, 2021 Accepting new patients
Dendrinos Medical Associates, P.a. Past Accepting new patients

Locations

1138 E Chestnut Ave
Bldg A
Vineland, NJ 08360
Phone (856) 691-1230

2020 E Chestnut Ave
Vineland, NJ 08361
Phone (856) 563-1600

76 S State St
Vineland, NJ 08360
Phone (856) 205-1112

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12810/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1613952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1396339107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 JANET ST",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083609616",
            "telephone_number": "609-364-4937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S WHITE HORSE PIKE",
            "city": "HAMMONTON",
            "state": "NJ",
            "postal_code": "080372014",
            "telephone_number": "609-270-4260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYER",
        "first_name": "ELIZABETH",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-22",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01099400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammonton, NJ

Sources for this page

Verify at the official NPI Registry.