Courtney Alyssa Chavan, MSN, APN, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Stafford Township, NJ
NPI 1780040337 · NPPES record last updated Feb 18, 2025
Key facts
- NPI
- 1780040337
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 26NJ00618300 (NJ)
- Practice address
- 1140 Route 72 W
Stafford Township, NJ 08050-2412 - Phone
- (609) 597-6011
- Fax
- (201) 968-0163
- NPI assigned
- Jan 12, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Plover Inpatient Services LLC
Practice addresses (Care Compare)
1140 Route 72 W
Manahawkin, NJ 08050-2412
Phone (609) 597-6011
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160401000546 | NJ | Practitioner - Nurse Practitioner | 2264739481 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing, Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hackensack Meridian Health Medical Group - Specialty Care PC | Current |
Accepting new patients | |
| Hackensack Meridian Health Medical Group - Specialty Care PC | Current |
Accepting new patients | |
| Coastal Infectious Disease Consultants, LLC | Current |
Accepting new patients | |
| Cardiovascular Associates of the Delaware Valley,P a | Past |
Accepting new patients |
Locations
30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066
4 W Roosevelt Blvd
Marmora, NJ 08223
Phone (609) 365-6202
1944 State Route 33
Neptune, NJ 07753
Phone (732) 776-3787
331 Newman Springs Rd
Ste 220
Red Bank, NJ 07701
Phone (732) 807-0514
1140 Route 72 W
Stafford Township, NJ 08050
Phone (609) 978-2194
425 Jack Martin Blvd
Wall Township, NJ 08724
Phone (732) 840-2200
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/IHJHBD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 26NJ00618300 | NJ | Yes |
Addresses
Primary practice location
1140 Route 72 W
Stafford Township, NJ 08050-2412
Mailing address
331 Newman Springs Rd Ste 220
Red Bank, NJ 07701-5792
Phone (732) 807-0877
Other providers in Stafford Township, NJ
- Jeffrey Allan Bates
- Thanh DO Calamito
- Michael S Cohen
- Community Options, Inc.
- Costco Wholesale Corporation
- Costco Wholesale Corporation
- Gia19
All providers in Stafford Township, NJ · Family Nurse Practitioner in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 18, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.