Jessica Arbeth Maddox Vann, APN

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

SP008840 Issued in PA

Practice address

106 Lupine LN
Penns Grove, NJ 08069-2241

Phone

(609) 617-5229

NPI assigned

Jan 10, 2007

Last updated

Oct 30, 2011By 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 names 1

• Mrs. Jessica Arbeth Maddox Former name

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Moonshot Psychiatric Nurse Practitioner PCGroup PAC ID 9335589696, 79 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Moonshot Psychiatric Nurse Practitioner PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Seattle, WA
  • NPI 1669158879

  NJ

  Medicare reassignment Care Compare group NPD
• Lavender New Jersey Psychiatric Nurse Practitioner PC

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
  • NPI 1629922950
  NPD

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319932800000",
    "number": "1710037163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 LUPINE LN",
            "city": "PENNS GROVE",
            "state": "NJ",
            "postal_code": "080692241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 LUPINE LN",
            "city": "PENNS GROVE",
            "state": "NJ",
            "postal_code": "080692241",
            "telephone_number": "609-617-5229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX VANN",
        "first_name": "JESSICA",
        "middle_name": "ARBETH",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2011-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP008840",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00325000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "MADDOX",
            "middle_name": "ARBETH",
            "prefix": "MRS.",
            "credential": "GNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eckerd Corporation (Eckerd)
• Margaret L. Fallstick, LPC
• Lizkebe Gado, NP
• Afshan Hasmani, PHARM D, CPI
• Judith Anne Kimmelman, D.M.D.
• Stephanie McCutcheon, BCBA, LBS, LBA
• My Team ABA NJ LLC
• Eric Myers
• Caroline Neblett
• Penns Grove - Carneys Point Reg SCH District

• Gerontology Nurse Practitioner in Penns Grove, NJ
• Providers in Penns Grove, NJ by specialty
• Gerontology Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2011; 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.