Individual provider Active NPI

Stephanie Michelle Shustock, MSN, APN

  • Adult Health Nurse Practitioner
  • Vineland, NJ
National Provider Identifier
1891941332
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00167900 Issued in NJ
Practice address
1317 S Main Rd
Unit 2C
Vineland, NJ 08360-6511
Phone
(856) 213-6080
Fax
(856) 213-6092
NPI assigned
Aug 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NJ00167900 NJ Primary

Addresses

Primary practice location

1317 S Main Rd
Unit 2C
Vineland, NJ 08360-6511

Mailing address

1317 S Main Rd
Unit 2C
Vineland, NJ 08360-6511
Phone (856) 213-6080

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
I20081103000371 NJ Practitioner - Nurse Practitioner 1850450040 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00167900NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Cumberland Medical Associates PC CurrentSince Nov 14, 2025 Accepting new patients

Locations

215 Back Neck Rd
Bridgeton, NJ 08302
Phone (609) 451-4414

Interoperability endpoints

  • Direct secure messaging: stephanie.shustock@scma.directbygreenway.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1891941332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 S MAIN RD",
            "address_2": "UNIT 2C",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083606511",
            "telephone_number": "856-213-6080",
            "fax_number": "856-213-6092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 S MAIN RD",
            "address_2": "UNIT 2C",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083606511",
            "telephone_number": "856-213-6080",
            "fax_number": "856-213-6092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUSTOCK",
        "first_name": "STEPHANIE",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "MSN, APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-15",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00167900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

Verify at the official NPI Registry.