Individual provider Active NPI

Wyndham Pursley, CRNP

  • Women's Health Nurse Practitioner
  • Moorestown, NJ
National Provider Identifier
1790784429
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
26NJ00318200 Issued in NJ
Practice address
401 Young Ave Ste 146D
Moorestown, NJ 08057-3130
Phone
(888) 982-3726
NPI assigned
Jul 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN345567L PA
Nurse Practitioner 363L00000X LG0000208 DE
Family Nurse Practitioner 363LF0000X ARNP9297250 FL
Family Nurse Practitioner 363LF0000X UP004711B PA
Family Nurse Practitioner 363LF0000X 26NJ00318200 NJ
Women's Health Nurse Practitioner 363LW0102X 26NJ00318200 NJ Primary

Addresses

Primary practice location

401 Young Ave Ste 146D
Moorestown, NJ 08057-3130

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197

Other practice location 1

106 Carnie Blvd
Voorhees, NJ 08043-4515
Phone (888) 982-3726

Other identifiers 1

IdentifierTypeStateIssuer
0001194842MedicaidDE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address wpursley12794@directvirtua.org
Direct Messaging Address wpursley12794@directvirtua.org

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
I20110427000169 NJ Practitioner - Nurse Practitioner 5597822635 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

3242 Route 206
Bordentown, NJ 08505-4517

Hospital & facility affiliations

  • Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057
  • West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022

Merit-based Incentive Payment System (MIPS)

Final score
81.15 of 100Reported as group
Quality
62.28
Promoting interoperability
100
Improvement activities
40
Cost
74.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN345567LPAMDRegistered Nurse
LG0000208DEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA Nurse Practitioner CurrentSince Jul 16, 2014 Accepting new patients
Virtua Medical Group, PA CurrentSince Jul 16, 2014 Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

401 Young Ave
Ste 146D
Moorestown, NJ 08057
Phone (888) 982-3726

401 Young Ave
Ste 380A
Moorestown, NJ 08057
Phone (856) 291-8650

7000 Atrium Way
Ste 6
Mount Laurel, NJ 08054
Phone (856) 206-4500

106 Carnie Blvd
Voorhees, NJ 08043
Phone (856) 325-4270

2301 E Evesham Rd
Ste 110B
Voorhees, NJ 08043

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 2

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": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1790784429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LIPPINCOTT DR STE 410",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 YOUNG AVE STE 146D",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573130",
            "telephone_number": "888-982-3726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 Carnie Blvd",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080434515",
            "country_code": "US",
            "telephone_number": "888-982-3726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PURSLEY",
        "first_name": "WYNDHAM",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-15",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN345567L",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LG0000208",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9297250",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "UP004711B",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00318200",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NJ",
            "license": "26NJ00318200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001194842",
            "state": "DE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wpursley12794@directvirtua.org",
            "affiliation": "N",
            "address_1": "106 Carnie Blvd",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080434515",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wpursley12794@directvirtua.org",
            "affiliation": "N",
            "address_1": "401 Young Ave Ste 146D",
            "city": "Moorestown",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080573130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Moorestown, NJ

Sources for this page

Verify at the official NPI Registry.