Individual provider Active NPI

Sharyn A Wills, APN

  • Pediatric Nurse Practitioner
  • Paterson, NJ
National Provider Identifier
1699812610
Registry record updated Sep 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
26NJ00052500 Issued in NJ
Practice address
90 Delaware Ave
Paterson, NJ 07503-1804
Phone
(973) 321-2256
Fax
(973) 321-2254
NPI assigned
Jan 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2009

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 26NJ00052500 NJ Primary

Addresses

Primary practice location

90 Delaware Ave
Paterson, NJ 07503-1804

Mailing address

12 Hazel St
Cranford, NJ 07016-2006
Phone (908) 272-1609

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

State licenses

LicenseStateTypeSpecialty
26NJ00052500NJMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254268800000",
    "number": "1699812610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 HAZEL ST",
            "city": "CRANFORD",
            "state": "NJ",
            "postal_code": "070162006",
            "telephone_number": "908-272-1609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 DELAWARE AVE",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075031804",
            "telephone_number": "973-321-2256",
            "fax_number": "973-321-2254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLS",
        "first_name": "SHARYN",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2009-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "26NJ00052500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2009; 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.