Individual provider Active NPI

Shayla J. Pearson, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Blackwood, NJ
National Provider Identifier
1760745707
Registry record updated May 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ00383900 Issued in NJ
Practice address
425 Woodbury Turnersville Rd
Blackwood, NJ 08012
Phone
(856) 374-6500
NPI assigned
Jun 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP01187 PA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ00383900 NJ Primary

Addresses

Primary practice location

425 Woodbury Turnersville Rd
Blackwood, NJ 08012

Mailing address

765 Route 70 E BLDG a-101
Marlton, NJ 08053-2341

Other names 1

  • Shayla J Edwards Former name

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
I20150818003245 NJ Practitioner - Nurse Practitioner 3971750217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Family Guidance PCGroup PAC ID 2860396454, 164 clinicians

Practice addresses (Care Compare)

333 Irving Ave
Bridgeton, NJ 08302-2123
Phone (609) 451-6600

425 Woodbury Turnersville Rd
Blackwood, NJ 08012-2960
Phone (856) 374-6600

Hospital & facility affiliations

  • Jefferson Stratford Hospital Hospital, Stratford, NJ, CCN 310086

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP01187PAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Family Guidance, PC Psychiatric/Mental Health CurrentSince Aug 1, 2015 Accepting new patients
Kids in Transition Past Accepting new patients

Locations

425 Woodbury Turnersville Rd
Blackwood, NJ 08012
Phone (856) 374-6500

333 Irving Ave
Bridgeton, NJ 08302
Phone (856) 575-4500

765 Route 70 E
Bldg A
Marlton, NJ 08053
Phone (856) 797-4721

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: shayla.pearson.p1@direct.cfg.nextgenshare.com

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 1

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": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527638400000",
    "number": "1760745707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 ROUTE 70 E BLDG A-101",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 WOODBURY TURNERSVILLE RD",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "08012",
            "telephone_number": "856-374-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "SHAYLA",
        "middle_name": "J.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-22",
        "last_updated": "2018-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP01187",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00383900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAYLA",
            "last_name": "EDWARDS",
            "middle_name": "J",
            "credential": "APN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Blackwood, NJ

Sources for this page

Verify at the official NPI Registry.