Individual provider Active NPI

Lorraine Michelle Santucci, PHD RN APNC

  • Nurse Practitioner
  • Millville, NJ
National Provider Identifier
1538154349
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NN07752400 Issued in NJ
Practice address
1014 N High St
Millville, NJ 08332-2527
Phone
(856) 690-0627
Fax
(856) 690-0627
NPI assigned
Sep 19, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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 26NN07752400 NJ Primary

Addresses

Primary practice location

1014 N High St
Millville, NJ 08332-2527

Mailing address

3284 Swan Dr
Vineland, NJ 08361-7367
Phone (856) 690-0612

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
I20050307000017 NJ Practitioner - Nurse Practitioner 6800840604 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jack M. Shields,M.D., PAGroup PAC ID 4688847023, 2 clinicians

Practice addresses (Care Compare)

1014 High St N
Millville, NJ 08332-2527
Phone (856) 690-0627

20 Magnolia Ave
Suite C
Bridgeton, NJ 08302-1759
Phone (856) 455-8833

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy, Registered Nurse

State licenses

LicenseStateTypeSpecialty
26NN07752400NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jack M. Shields,M.D., PA CurrentSince Sep 26, 2011 Accepting new patients
The Wholistic Center for Wellness Inc CurrentSince Oct 1, 2004 Accepting new patients

Locations

20 Magnolia Ave
Ste C
Bridgeton, NJ 08302
Phone (609) 455-8833

1014 High St N
Millville, NJ 08332
Phone (856) 327-0320

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.

NPI Registry JSON

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1538154349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3284 SWAN DR",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083617367",
            "telephone_number": "856-690-0612",
            "fax_number": "856-690-0627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 N HIGH ST",
            "city": "MILLVILLE",
            "state": "NJ",
            "postal_code": "083322527",
            "telephone_number": "856-690-0627",
            "fax_number": "856-690-0627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTUCCI",
        "first_name": "LORRAINE",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "PHD RN APNC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-19",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NN07752400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millville, NJ

Sources for this page

Verify at the official NPI Registry.