Individual provider Active NPI

Jamie Ann Debouno, NP-C

  • Nurse Practitioner
  • Northfield, NJ
National Provider Identifier
1396989083
Registry record updated Dec 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ00185000 Issued in NJ
Practice address
1907 New Rd
Northfield, NJ 08225-1545
Phone
(609) 645-8884
NPI assigned
Apr 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2018

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 26NR129390000 NJ
Registered Nurse 163W00000X RN575581 PA
Adult Health Nurse Practitioner 363LA2200X SP010169 PA
Family Nurse Practitioner 363LF0000X SP011146 PA
Nurse Practitioner 363L00000X 26NJ00185000 NJ Primary

Addresses

Primary practice location

1907 New Rd
Northfield, NJ 08225-1545

Mailing address

151 Fries Mill Rd
Ste 202
Blackwood, NJ 08012-2057
Phone (855) 727-2465

Other names 1

  • Jamie Ann Debouno Professional name

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

State licenses

LicenseStateTypeSpecialty
26NR129390000NJMDRegistered Nurse
26NJ00185000NJMDNurse Practitioner
SP011146PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rami E Geffner MD PA Past Accepting new patients
Dendrinos Medical Associates, P.a. Past Accepting new patients
Visiting Physician Associates of South Jersey LLC Past Accepting new patients

Organizations & group practices 3

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": "1240531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543881600000",
    "number": "1396989083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 FRIES MILL RD",
            "address_2": "STE 202",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080122057",
            "telephone_number": "855-727-2465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 NEW RD",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082251545",
            "telephone_number": "609-645-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBOUNO",
        "first_name": "JAMIE ANN",
        "name_prefix": "Miss",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-24",
        "last_updated": "2018-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR129390000",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN575581",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP010169",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP011146",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00185000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE ANN",
            "last_name": "DEBOUNO",
            "credential": "NP-C, RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Northfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.