Individual provider Active NPI

Rebecca Jean Stanwood, C.P.N.P

  • Pediatric Nurse Practitioner
  • West Deptford, NJ
National Provider Identifier
1427359462
Registry record updated Jun 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
26NJ00310100 Issued in NJ
Practice address
646 Kings Hwy
West Deptford, NJ 08096-3145
Phone
(856) 879-2887
Fax
(856) 879-2855
NPI assigned
Nov 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 26NJ00310100 NJ Primary

Addresses

Primary practice location

646 Kings Hwy
West Deptford, NJ 08096-3145

Mailing address

402 Lippincott Dr
Marlton, NJ 08053-4112
Phone (856) 782-3300

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
I20220411002392 NJ Practitioner - Nurse Practitioner 7517192545 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00310100NJMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advocare, LLC CurrentSince Mar 4, 2022 Accepting new patients
Advocare , LLC CurrentSince Mar 4, 2022 Accepting new patients
Children'S Surgical Associates of New Jersey Inc Past Accepting new patients
Children'S Surgical Associates LTD Past Accepting new patients

Locations

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033

402 Lippincott Dr
Marlton, NJ 08053
Phone (410) 763-8787

19 Village Center Dr
Swedesboro, NJ 08085
Phone (856) 468-8330

646 Kings Hwy
West Deptford, NJ 08096
Phone (856) 879-2887

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1289174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308528000000",
    "number": "1427359462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 LIPPINCOTT DR",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534112",
            "telephone_number": "856-782-3300",
            "fax_number": "856-504-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 KINGS HWY",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "080963145",
            "telephone_number": "856-879-2887",
            "fax_number": "856-879-2855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANWOOD",
        "first_name": "REBECCA",
        "middle_name": "JEAN",
        "credential": "C.P.N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-08",
        "last_updated": "2011-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "26NJ00310100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Deptford, NJ

Sources for this page

Verify at the official NPI Registry.