Active NPI
Staci Brooks
- Diagnostic Ultrasound Physician
- Swedesboro, NJ
National Provider Identifier
1891513388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Ultrasound Physician
- License
- 191941
- Practice address
- 499 Beckett Rd Ste 202
Swedesboro, NJ 08085-1771 - Phone
- (856) 746-0220
- NPI assigned
- Oct 2, 2024
- Last updated
- Oct 2, 2024
- 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 |
|---|---|---|---|---|
| Diagnostic Ultrasound Physician | 2085U0001X | 191941 | NJ | Primary |
Addresses
Primary practice location
499 Beckett Rd Ste 202
Swedesboro, NJ 08085-1771
Mailing address
534 Majestic Ave
Bellmawr, NJ 08031-1460
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 |
|---|---|---|---|
| 191941 | NJ | MD | Diagnostic Ultrasound Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727827200000",
"number": "1891513388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "534 MAJESTIC AVE",
"city": "BELLMAWR",
"state": "NJ",
"postal_code": "080311460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "499 BECKETT RD STE 202",
"city": "SWEDESBORO",
"state": "NJ",
"postal_code": "080851771",
"telephone_number": "856-746-0220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "STACI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-02",
"last_updated": "2024-10-02",
"certification_date": "2024-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "2085U0001X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Ultrasound",
"state": "NJ",
"license": "191941",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Swedesboro, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.