Shandel Douglas, APN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ00747600 Issued in NJ

Practice address

887 Kinderkamack Rd
River Edge, NJ 07661-2307

Phone

(201) 464-0860

NPI assigned

Aug 31, 2017

Last updated

Dec 31, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lifebulb LLCGroup PAC ID 2062881162, 97 clinicians

Evergreen Medical Group PCGroup PAC ID 2769929082, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Evergreen Medical Group PC

  • Physical Medicine & Rehabilitation Physician
  • River Edge, NJ
  • NPI 1295516409

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Lifebulb LLC

  • Mental Health Counselor
  • Toms River, NJ
  • NPI 1699491464
  Medicare reassignment Care Compare group NPD
• Freeway Psychiatry PC

  • Psychiatry Physician
  • North Bergen, NJ
  • NPI 1831819531
  Medicare reassignment NPD
• Harmony Medical Services of New Jersey LLC

  dba Harmonycares Medical Group

  • Family Medicine Physician
  • Montclair, NJ
  • NPI 1649873183
  Medicare reassignment NPD
• JLS Medical PC

  dba Wellbrook Health

  • Psychiatry Physician
  • Newark, NJ
  • NPI 1164007043

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Visiting Nurse Association of Central Jersey, Inc.

  • Geriatric Medicine (Family Medicine) Physician
  • Holmdel, NJ
  • NPI 1336195791
  Medicare reassignment NPD
• VPS Medical Services, PC

  • Internal Medicine Physician
  • Neptune, NJ
  • NPI 1265077739
  Medicare reassignment NPD
• Harmony Medical Services of New Jersey LLC

  dba Harmonycares Medical Group

  • Family Medicine Physician
  • Montclair, NJ
  • NPI 1356048573
  NPD
• Visiting Nurse Association of Central Jersey, Inc.

  • Home Health Agency
  • Holmdel, NJ
  • NPI 1144275892
  NPD
• Thrive Counseling LLC

  dba Thriveworks

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300
  NPD
• Bancroft, a New Jersey Nonprofit Corporation

  • Rehabilitation Clinic/Center
  • Cherry Hill, NJ
  • NPI 1720121106
  NPD (past)
• The Heart Center of the Oranges

  • Internal Medicine Physician
  • West Orange, NJ
  • NPI 1336657840
  NPD (past)

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767139200000",
    "number": "1649798455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "887 KINDERKAMACK RD",
            "city": "RIVER EDGE",
            "state": "NJ",
            "postal_code": "076612307",
            "telephone_number": "201-464-0860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "887 KINDERKAMACK RD",
            "city": "RIVER EDGE",
            "state": "NJ",
            "postal_code": "076612307",
            "telephone_number": "201-464-0860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "SHANDEL",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-31",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00747600",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ00747600",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0587613",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandria Devito
• Damian Joseph Dilauri, RPH
• Shira Deborah Donath, PSY.D.
• Sharon Doni
• Benjamin Donson, MSED, BCBA
• Dr. Jeanette Honig,Chiropractor LLC
• Delia Duran
• Eastern Acupuncture & Herbs PC
• Charles Ehrlich, LDS
• Eihab Human Services New Jersey, Inc.

• Psychiatric/Mental Health Nurse Practitioner in River Edge, NJ
• Providers in River Edge, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.