Individual provider Active NPI

Patrick Andrew Stockton, CPNP-PC, RN

  • Pediatric Nurse Practitioner
  • JB MDL, NJ
National Provider Identifier
1679091706
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN2307154 Issued in MA
Practice address
3458 Neely Rd
JB MDL, NJ 08641-5312
Phone
(609) 754-9103
NPI assigned
Sep 9, 2017
Last updated
Sep 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN2307154 MA Primary

Addresses

Primary practice location

3458 Neely Rd
JB MDL, NJ 08641-5312

Mailing address

3458 Neely Rd
Joint Base MDL, NJ 08641-5312
Phone (609) 754-9103

Other practice location 1

697 Louisiana Rd
Dyess AFB, TX 79607-1141
Phone (325) 696-4677

Other practice location 2

7219 N Litchfield Rd
Luke AFB, AZ 85309-1529
Phone (623) 856-2273

Other names 1

  • Patrick Andrew Carrera Former 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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN2307154MAMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1504915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1679091706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3458 NEELY RD",
            "city": "JOINT BASE MDL",
            "state": "NJ",
            "postal_code": "086415312",
            "telephone_number": "609-754-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3458 NEELY RD",
            "city": "JB MDL",
            "state": "NJ",
            "postal_code": "086415312",
            "telephone_number": "609-754-9103"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "697 Louisiana Rd",
            "address_purpose": "LOCATION",
            "city": "Dyess AFB",
            "state": "TX",
            "postal_code": "796071141",
            "country_code": "US",
            "telephone_number": "325-696-4677",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7219 N Litchfield Rd",
            "address_purpose": "LOCATION",
            "city": "Luke AFB",
            "state": "AZ",
            "postal_code": "853091529",
            "country_code": "US",
            "telephone_number": "623-856-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOCKTON",
        "first_name": "PATRICK",
        "middle_name": "ANDREW",
        "credential": "CPNP-PC, RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-09",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "RN2307154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICK",
            "last_name": "CARRERA",
            "middle_name": "ANDREW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in JB MDL, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; 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.