Active NPI
Jacqueline Boyd
- Licensed Practical Nurse
- Pennsauken, NJ
National Provider Identifier
1790201986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 26NP05782800
- Practice address
- 2500 McClellan Ave Ste 300
Pennsauken, NJ 08109-0001 - Phone
- (856) 488-1583
- NPI assigned
- Aug 18, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 26NP05782800 | NJ | Primary |
Addresses
Primary practice location
2500 McClellan Ave Ste 300
Pennsauken, NJ 08109-0001
Mailing address
2500 McClellan Avenue
Suite: 300
Pennsauken, NJ 08109
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
| License | State | Type | Specialty |
|---|---|---|---|
| 26NP05782800 | NJ | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1503014400000",
"number": "1790201986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 MCCLELLAN AVENUE",
"address_2": "SUITE: 300",
"city": "PENNSAUKEN",
"state": "NJ",
"postal_code": "08109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 MCCLELLAN AVE STE 300",
"city": "PENNSAUKEN",
"state": "NJ",
"postal_code": "081090001",
"telephone_number": "856-488-1583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYD",
"first_name": "JACQUELINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-18",
"last_updated": "2017-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NJ",
"license": "26NP05782800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pennsauken, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.