Debra Fenderson-Ivery

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

26NJ00743900 Issued in NJ

Practice address

404 Creek Crossing Blvd
Hainesport, NJ 08036-2768

Phone

(609) 845-3988

NPI assigned

Feb 19, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Naspac1 LLCGroup PAC ID 1355563404, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Naspac1 LLC

  dba North american spine and pain consultants

  • Pain Medicine (Anesthesiology) Physician
  • Hainesport, NJ
  • NPI 1528483245

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Naspac1 LLC

  • Interventional Pain Medicine Physician
  • East Orange, NJ
  • NPI 1720756216
  NPD

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

{
    "created_epoch": "1518998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518998400000",
    "number": "1902306624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 CREEK CROSSING BLVD",
            "city": "HAINESPORT",
            "state": "NJ",
            "postal_code": "080362768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 CREEK CROSSING BLVD",
            "city": "HAINESPORT",
            "state": "NJ",
            "postal_code": "080362768",
            "telephone_number": "609-845-3988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENDERSON-IVERY",
        "first_name": "DEBRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-19",
        "last_updated": "2018-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00743900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacey Dickinson, BCBA
• Rachel Dinkler, NP-C
• Dva Healthcare Renal Care Inc (Lumberton Dialysis)
• Sarah M EMS, APN
• Blake Feingold, PA-C
• Alexander Ferrara, OTR
• Kendra Fiorvante
• Michael Joseph Fitzpatrick, DMD
• Richard A Forberg, EMT
• Michael Fox, DC

• Adult Health Nurse Practitioner in Hainesport, NJ
• Providers in Hainesport, NJ by specialty
• Adult Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.