Individual provider Active NPI

Clayton Joseph Cowan, MD

  • Anesthesiology Physician
  • Mount Holly, NJ
National Provider Identifier
1871599563
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA08205700 Issued in NJ
Practice address
175 Madison Ave FL 1
Mount Holly, NJ 08060-2099
Phone
(609) 914-6000
NPI assigned
Jun 27, 2005
Last updated
Oct 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA08205700 NJ Primary
Anesthesiology Physician 207L00000X MD-055431L PA

Addresses

Primary practice location

175 Madison Ave FL 1
Mount Holly, NJ 08060-2099

Mailing address

1 Concord LN
Voorhees, NJ 08043-2829
Phone (856) 753-7674

Other practice location 1

175 High St
Newton, NJ 07860-1004
Phone (973) 383-2121

Other identifiers 1

IdentifierTypeStateIssuer
01528246MedicaidPA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ccowan184223@directvirtua.org
Direct Messaging Address ccowan184223@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070716000553 NJ Practitioner - Anesthesiology 6406741628 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA08205700NJMDAnesthesiology Physician
MD-055431LPAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey Healthcare Specialists PC Anesthesiology CurrentSince Jun 4, 2017 Accepting new patients
North American Partners in Anesthesia of New Jersey LLC Anesthesiology CurrentSince Aug 1, 2014 Accepting new patients
Virtua Medical Group, PA Anesthesiology CurrentSince Oct 4, 2023 Accepting new patients
Virtua Medical Group, PA CurrentSince Oct 4, 2023 Accepting new patients
Laurel Group Anesthesia PC PastSince Oct 1, 2006 Accepting new patients
Darby Anesthesia Associates Inc Anesthesiology Past Accepting new patients
Burlington Anesthesia Associates, PA Anesthesiology Past Accepting new patients
Liberty Anesthesia Associates, P. C. Past Accepting new patients

Locations

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

901 W Main St
Freehold, NJ 07728
Phone (732) 294-2666

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

300 2nd Ave
Long Branch, NJ 07740
Phone (732) 222-5200

175 Madison Ave
Mount Holly, NJ 08060
Phone (609) 261-1660

175 Madison Ave
Fl 1
Mount Holly, NJ 08060
Phone (609) 914-6000

175 High St
Newton, NJ 07860
Phone (973) 383-2121

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

1505 W Sherman Ave
Vineland, NJ 08360
Phone (856) 451-6600

Interoperability endpoints

  • Direct secure messaging: ccowan184223@directvirtua.org

Organizations & group practices 8

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1871599563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CONCORD LN",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080432829",
            "telephone_number": "856-753-7674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 MADISON AVE FL 1",
            "city": "MOUNT HOLLY",
            "state": "NJ",
            "postal_code": "080602099",
            "telephone_number": "609-914-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 High St",
            "address_purpose": "LOCATION",
            "city": "Newton",
            "state": "NJ",
            "postal_code": "078601004",
            "country_code": "US",
            "telephone_number": "973-383-2121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COWAN",
        "first_name": "CLAYTON",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA08205700",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD-055431L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01528246",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccowan184223@directvirtua.org",
            "affiliation": "N",
            "address_1": "175 Madison Ave Fl 1",
            "city": "Mount Holly",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080602099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccowan184223@directvirtua.org",
            "affiliation": "N",
            "address_1": "218 Sunset Rd Fl 2",
            "city": "Willingboro",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080461110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Holly, NJ

Sources for this page

Verify at the official NPI Registry.