Active NPI
Clayton Joseph Cowan, MD
- Anesthesiology Physician
- Mount Holly, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 25MA08205700
- 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, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01528246 | Medicaid | PA |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA08205700 | NJ | MD | Anesthesiology Physician |
| MD-055431L | PA | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Jersey Healthcare Specialists PC | Anesthesiology | Current | Accepting new patients |
| North American Partners in Anesthesia of New Jersey LLC | Anesthesiology | Current | Accepting new patients |
| Virtua Medical Group, PA | Anesthesiology | Current | Accepting new patients |
| Virtua Medical Group, PA | Current | Accepting new patients | |
| Laurel Group Anesthesia PC | Past | 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
- 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.
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- NPI 1548433048
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- NPI 1841087988
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- Anesthesiology Physician
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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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.