Individual provider Active NPI

Ralph N Daggan III, CRNA

  • Certified Registered Nurse Anesthetist
  • Camden, NJ
National Provider Identifier
1477641405
Registry record updated Apr 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NO07823500 Issued in NJ
Practice address
1 Cooper PLZ
Dept of Anestheisa
Camden, NJ 08103-1461
Phone
(856) 342-2425
Fax
(856) 968-8239
NPI assigned
Oct 11, 2006
Last updated
Apr 12, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NO07823500 NJ Primary
Certified Registered Nurse Anesthetist 367500000X RN272385L PA

Addresses

Primary practice location

1 Cooper PLZ
Dept of Anestheisa
Camden, NJ 08103-1461

Mailing address

1 Federal St
Ste Sw200
Camden, NJ 08103-1155
Phone (856) 382-6530

Other identifiers 1

IdentifierTypeStateIssuer
010007379OtherNJAMERICHOICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080502000008 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 0345329363 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
NO07823500NJMDCertified Registered Nurse Anesthetist
RN272385LPAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Shrewsbury Ambulatory Anesthesia LLC CurrentSince Mar 23, 2024 Accepting new patients
Cooper Anesthesia Associates, PC CurrentSince Mar 9, 1995 Accepting new patients
CHC Pain Management Center, PA CurrentSince May 18, 2014 Accepting new patients
Virtua Medical Group, PA Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920

3 Cooper Plz
Rm 104
Camden, NJ 08103
Phone (609) 963-6770

3 Cooper Plz
Rm 314
Camden, NJ 08103
Phone (609) 963-6770

130 Gaither Dr
Ste 160
Mount Laurel, NJ 08054
Phone (609) 722-7000

655 Shrewsbury Ave
Shrewsbury, NJ 07702
Phone (732) 450-6000

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.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1477641405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST",
            "address_2": "STE SW200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031155",
            "telephone_number": "856-382-6530",
            "fax_number": "856-968-8499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ",
            "address_2": "DEPT OF ANESTHEISA",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461",
            "telephone_number": "856-342-2425",
            "fax_number": "856-968-8239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGGAN",
        "first_name": "RALPH",
        "middle_name": "N",
        "name_suffix": "III",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "NO07823500",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN272385L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "010007379",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.