Individual provider Active NPI

Colleen Slough, CRNP

  • Nurse Practitioner
  • Mount Laurel, NJ
National Provider Identifier
1609529973
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ14934200 Issued in NJ
Practice address
501 Fellowship Rd Ste 101
Mount Laurel, NJ 08054-3419
Phone
(856) 642-2133
NPI assigned
Jan 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SP025209 PA
Nurse Practitioner 363L00000X 26NJ14934200 NJ Primary

Addresses

Primary practice location

501 Fellowship Rd Ste 101
Mount Laurel, NJ 08054-3419

Mailing address

1 Federal St Ste 200
Camden, NJ 08103-1088
Phone (848) 288-6935

Other practice location 1

111 S 11th St
Philadelphia, PA 19107-4824
Phone (267) 624-7257

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
I20231115000080 NJ Practitioner - Nurse Practitioner 0244626208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cooper Surgical Associates, PAGroup PAC ID 3274430764, 303 clinicians

Practice addresses (Care Compare)

2339 Route 70 W
Cherry Hill, NJ 08002-3315

3 Cooper PLZ
Camden, NJ 08103-1438

6200 Main St
Voorhees, NJ 08043-4629
Phone (856) 325-6516

6200 Plazza at Main St
Voorhees, NJ 08043-4629
Phone (856) 489-7726

6225 Main St
Voorhees, NJ 08043-4629
Phone (856) 325-6674

Hospital & facility affiliations

  • Cooper University Hospital Hospital, Camden, NJ, CCN 310014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP025209PAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Surgical Associates, PA CurrentSince Oct 1, 2023 Accepting new patients
Cooper Surgical Associates, PA CurrentSince Oct 1, 2023 Accepting new patients

Locations

2 Cooper Plz
Fl 2
Camden, NJ 08103

3 Cooper Plz
Rm 411
Camden, NJ 08103
Phone (856) 342-2270

2339 Route 70 W
Cherry Hill, NJ 08002
Phone (856) 406-4080

400 W Route 38
Moorestown, NJ 08057
Phone (856) 270-4000

501 Fellowship Rd
Ste 101
Mount Laurel, NJ 08054
Phone (856) 963-3572

6015 Main St
Ste G
Voorhees, NJ 08043
Phone (856) 325-6565

Interoperability endpoints

  • Direct secure messaging: cslough174043@direct.cooperhealth.edu

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.

Hospital & facility affiliations 2

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": "1643241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1609529973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST STE 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "848-288-6935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 FELLOWSHIP RD STE 101",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080543419",
            "telephone_number": "856-642-2133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 S 11th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074824",
            "country_code": "US",
            "telephone_number": "267-624-7257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLOUGH",
        "first_name": "COLLEEN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-27",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP025209",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ14934200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

Verify at the official NPI Registry.