Individual provider Active NPI

Shay N. Tomlin, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Sewell, NJ
National Provider Identifier
1780983601
Registry record updated Feb 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ00622500 Issued in NJ
Practice address
1070 Main St
Sewell, NJ 08080-4554
Phone
(856) 256-3320
Fax
(856) 256-3328
NPI assigned
Mar 17, 2011
Last updated
Feb 25, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X L8-0000138 DE
Registered Nurse 163W00000X L1-0037851 DE
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ00622500 NJ Primary

Addresses

Primary practice location

1070 Main St
Sewell, NJ 08080-4554

Mailing address

309 W Commerce Ext
Bridgeton, NJ 08302-1442
Phone (856) 455-5271

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
I20170329002549 NJ Practitioner - Nurse Practitioner 9133438708 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clarity Psychiatric CareGroup PAC ID 2365836020, 14 clinicians
Center for Family Guidance PCGroup PAC ID 2860396454, 164 clinicians

Practice addresses (Care Compare)

2 Split Rock Dr
Suite 11
Cherry Hill, NJ 08003-1244
Phone (856) 428-1260

765 Route 70 E
BLDG a
Marlton, NJ 08053-2341
Phone (856) 983-3900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L1-0037851DEMDRegistered Nurse
26NJ00622500NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CMC Psychiatric Associates, PC CurrentSince Aug 16, 2021 Accepting new patients

Locations

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

3 Cooper Plz
Rm 104
Camden, NJ 08103
Phone (609) 963-6770

Interoperability endpoints

  • Direct secure messaging: shay.tomlin.p1@direct.cfg.nextgenshare.com

Organizations & group practices 3

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.

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": "1300320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1780983601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 W COMMERCE EXT",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "083021442",
            "telephone_number": "856-455-5271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 MAIN ST",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080804554",
            "telephone_number": "856-256-3320",
            "fax_number": "856-256-3328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMLIN",
        "first_name": "SHAY",
        "middle_name": "N.",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-17",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DE",
            "license": "L8-0000138",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DE",
            "license": "L1-0037851",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00622500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sewell, NJ

Sources for this page

Verify at the official NPI Registry.