Individual provider Active NPI

Paula Preston-Dougherty, MSN

  • Family Nurse Practitioner
  • Medford, NJ
National Provider Identifier
1427423920
Registry record updated Oct 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00622100 Issued in NJ
Practice address
128 Route 70
Medford, NJ 08055-2371
Phone
(609) 953-7105
Fax
(609) 953-7110
NPI assigned
Dec 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 26NR15684900 NJ
Family Nurse Practitioner 363LF0000X 26NJ00622100 NJ Primary

Addresses

Primary practice location

128 Route 70
Medford, NJ 08055-2371

Mailing address

7000 Atrium Way Ste 6
Mount Laurel, NJ 08054-3917
Phone (856) 206-4508

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pprestondougherty12868@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
I20160609000055 NJ Practitioner - Nurse Practitioner 8729378427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
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)

128 Route 70
Medford, NJ 08055-2371

305 Route 70 E
Cherry Hill, NJ 08034-2408

315 Route 70 E
Vitua Express Urgent Care Cherry Hill
Cherry Hill, NJ 08034-2408
Phone (856) 375-6240

3242 Route 206
Bordentown, NJ 08505-4517

602 W Cuthbert Blvd
Unit 26
Haddon Township, NJ 08108-3642
Phone (856) 946-5180

Hospital & facility affiliations

  • Virtua Home Care at West Jersey Home health agency, Marlton, NJ, CCN 317071
  • Bayada Home Health Care, Inc Home health agency, Pennsauken, NJ, CCN 317065
  • Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057
  • West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022
  • Virtua Willingboro Hospital Hospital, Willingboro, NJ, CCN 310061
  • Virtua Our Lady of Lourdes Hospital Hospital, Camden, NJ, CCN 310029

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00622100NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Apr 6, 2016 Accepting new patients
Virtua Medical Group, PA Current Accepting new patients
Virtua Medical Group, PA CurrentSince Apr 6, 2016 Accepting new patients

Locations

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

128 Route 70
Medford, NJ 08055
Phone (609) 367-0900

7000 Atrium Way
Ste 6
Mount Laurel, NJ 08054
Phone (856) 206-4500

Interoperability endpoints

  • Direct secure messaging: pprestondougherty12868@directvirtua.org

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.

Hospital & facility affiliations 9

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": "1449619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602979200000",
    "number": "1427423920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 ATRIUM WAY STE 6",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080543917",
            "telephone_number": "856-206-4508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 ROUTE 70",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080552371",
            "telephone_number": "609-953-7105",
            "fax_number": "609-953-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTON-DOUGHERTY",
        "first_name": "PAULA",
        "credential": "MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-09",
        "last_updated": "2020-10-18",
        "certification_date": "2020-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR15684900",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00622100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pprestondougherty12868@directvirtua.org",
            "affiliation": "N",
            "address_1": "128 Route 70",
            "city": "Medford",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080552371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Medford, NJ

Sources for this page

Verify at the official NPI Registry.