Individual provider Active NPI

Carolyn Ann Nelson, APN

  • Adult Health Nurse Practitioner
  • Egg Harbor Township, NJ
National Provider Identifier
1407199086
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00457500 Issued in NJ
Practice address
2500 English Creek Ave
BLDG 900, Ste 904
Egg Harbor Township, NJ 08234
Phone
(609) 407-2243
NPI assigned
Apr 1, 2013
Last updated
Sep 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NJ00457500 NJ Primary

Addresses

Primary practice location

2500 English Creek Ave
BLDG 900, Ste 904
Egg Harbor Township, NJ 08234

Mailing address

3600 Route 66
3Rd FL
Neptune, NJ 07753-2645

Other practice location 1

408 Bethel Rd
Somers Point, NJ 08244-2172
Phone (609) 926-3330

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
I20140103000222 NJ Practitioner - Nurse Practitioner 5597993279 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlanticare Physician Group PAGroup PAC ID 8527953660, 506 clinicians

Practice addresses (Care Compare)

459 Route 9 S
Little Egg Harbor TWP, NJ 08087-2225
Phone (609) 340-7815

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanticare Physician Group, PA CurrentSince Sep 1, 2023 Accepting new patients
Atlanticare Physician Group PA CurrentSince Sep 1, 2023 Accepting new patients
Allied Digestive Health, LLC CurrentSince May 29, 2021 Accepting new patients
Atlantic Coast Gastroenterology Associates Past Accepting new patients

Locations

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

408 Bethel Rd
Ste E
Somers Point, NJ 08244
Phone (609) 926-3330

1640 Route 88 W
Ste 202
Wall Township, NJ 08724
Phone (732) 370-2220

Interoperability endpoints

  • Direct secure messaging: carolyn.nelson.1@24721.direct.athenahealth.com

Organizations & group practices 4

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": "1364774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1407199086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 ROUTE 66",
            "address_2": "3RD FL",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077532645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 ENGLISH CREEK AVE",
            "address_2": "BLDG 900, STE 904",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "08234",
            "telephone_number": "609-407-2243"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "408 Bethel Rd",
            "address_purpose": "LOCATION",
            "city": "Somers Point",
            "state": "NJ",
            "postal_code": "082442172",
            "country_code": "US",
            "telephone_number": "609-926-3330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "CAROLYN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-01",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00457500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Egg Harbor Township, NJ

Sources for this page

Verify at the official NPI Registry.