Prudent Clinical Providers Corp

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

Legal business name

PRUDENT CLINICAL PROVIDERS CORP

Practice address

2411 Greenwood Dr
Lindenwold, NJ 08021-6787

Phone

(856) 842-6677

NPI assigned

Jan 24, 2020

Organization subpart

No

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

Authorized official

Name

Melissa Beth Marcelle, NP

Title

NP/Ceo

Phone

(856) 842-6677

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583280000000",
    "number": "1447880810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2411 GREENWOOD DR",
            "city": "LINDENWOLD",
            "state": "NJ",
            "postal_code": "080216787",
            "telephone_number": "856-842-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 GREENWOOD DR",
            "city": "LINDENWOLD",
            "state": "NJ",
            "postal_code": "080216787",
            "telephone_number": "856-842-6677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2411 Greenwood Dr",
            "address_purpose": "LOCATION",
            "city": "Lindenwold",
            "state": "NJ",
            "postal_code": "080216787",
            "country_code": "US",
            "telephone_number": "856-842-6677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRUDENT CLINICAL PROVIDERS CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-24",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A",
        "authorized_official_last_name": "MARCELLE",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "NP/CEO",
        "authorized_official_telephone_number": "856-842-6677",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gerontology Nurse Practitioner in Lindenwold, NJ
• Providers in Lindenwold, NJ by specialty
• Gerontology Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.