Individual provider Active NPI

Charmaine M Cirino Thomas, FNP - BC

  • Family Nurse Practitioner
  • Glassboro, NJ
National Provider Identifier
1588074173
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00537300 Issued in NJ
Practice address
201 Mullica Hill Rd
Glassboro, NJ 08028-1700
Phone
(856) 256-4333
Fax
(856) 256-4427
NPI assigned
May 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00537300 NJ Primary

Addresses

Primary practice location

201 Mullica Hill Rd
Glassboro, NJ 08028-1700

Mailing address

201 Mullica Hill Rd
Glassboro, NJ 08028-1700
Phone (856) 256-4333

Other identifiers 1

IdentifierTypeStateIssuer
0449555MedicaidNJ

Other names 1

  • Charmaine Cirino Thomas Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00537300NJMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1588074173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 MULLICA HILL RD",
            "city": "GLASSBORO",
            "state": "NJ",
            "postal_code": "080281700",
            "telephone_number": "856-256-4333",
            "fax_number": "856-256-4427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 MULLICA HILL RD",
            "city": "GLASSBORO",
            "state": "NJ",
            "postal_code": "080281700",
            "telephone_number": "856-256-4333",
            "fax_number": "856-256-4427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIRINO THOMAS",
        "first_name": "CHARMAINE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "FNP - BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-05",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00537300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0449555",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARMAINE",
            "last_name": "THOMAS",
            "middle_name": "CIRINO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Glassboro, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.