Individual provider Active NPI

Cortney Shana Griffin, APN

  • Nurse Practitioner
  • Hainesport, NJ
National Provider Identifier
1407366164
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ00701900 Issued in NJ
Practice address
310 Creek Crossing Blvd
Hainesport, NJ 08036-2767
Phone
(609) 702-0014
Fax
(609) 702-7225
NPI assigned
Oct 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ00701900 NJ Primary

Addresses

Primary practice location

310 Creek Crossing Blvd
Hainesport, NJ 08036-2767

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 355-0340

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cgriffin182669@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
I20180409002009 NJ Practitioner - Nurse Practitioner 7618230426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

310 Creek Crossing Blvd
Hainesport, NJ 08036-2767
Phone (609) 702-0014

3242 Route 206
Bordentown, NJ 08505-4517

Hospital & facility affiliations

  • Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057
  • Virtua Willingboro Hospital Hospital, Willingboro, NJ, CCN 310061
  • West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00701900NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA Nurse Practitioner CurrentSince Jan 1, 2021 Accepting new patients
Virtua Medical Group, PA CurrentSince Jan 1, 2021 Accepting new patients

Locations

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

811 Sunset Rd
Burlington, NJ 08016
Phone (609) 387-9242

310 Creek Crossing Blvd
Hainesport, NJ 08036
Phone (609) 702-0014

303 Lippincott Dr
Marlton, NJ 08053

141 Route 70 E
Ste E
Marlton, NJ 08053
Phone (856) 985-7373

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

Interoperability endpoints

  • Direct secure messaging: cgriffin182669@directvirtua.org

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.

Hospital & facility affiliations 3

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": "1507507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1407366164",
    "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": "856-355-0340",
            "fax_number": "856-355-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 CREEK CROSSING BLVD",
            "city": "HAINESPORT",
            "state": "NJ",
            "postal_code": "080362767",
            "telephone_number": "609-702-0014",
            "fax_number": "609-702-7225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "CORTNEY",
        "middle_name": "SHANA",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-09",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00701900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cgriffin182669@directvirtua.org",
            "affiliation": "N",
            "address_1": "310 Creek Crossing Blvd",
            "city": "Hainesport",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080362767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hainesport, NJ

Sources for this page

Verify at the official NPI Registry.