Individual provider Active NPI

Patti C Fellows, APRN BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Northfield, NJ
National Provider Identifier
1922101013
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ00027300 Issued in NJ
Practice address
505 New Rd
Northfield, NJ 08225-1609
Phone
(609) 892-3758
NPI assigned
Sep 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ00027300 NJ Primary

Addresses

Primary practice location

505 New Rd
Northfield, NJ 08225-1609

Mailing address

505 New Rd
Northfield, NJ 08225-1609
Phone (609) 892-3758

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
I20040611000103 NJ Practitioner - Nurse Practitioner 7618950528 Reassigns benefits to 1 organization
Practice locations: Swainton, NJ

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1419 US Hwy 9
Swainton, NJ 08210
Phone (609) 465-2260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00027300NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cooperative Care Partnership, Inc CurrentSince Dec 1, 2014 Accepting new patients
Cooperative Care Partnership, Inc. PastSince Dec 1, 2014 Accepting new patients
Family Service Association Past Accepting new patients
Family Service Association Past Accepting new patients
Vericare Behavioral Health of New Jersey, P.a. Psychiatric/Mental Health Past Accepting new patients

Locations

1076 Route 47 S
Rio Grande, NJ 08242
Phone (609) 741-6363

Organizations & group practices 5

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": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1922101013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 NEW RD",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082251609",
            "telephone_number": "609-892-3758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 NEW RD",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082251609",
            "telephone_number": "609-892-3758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELLOWS",
        "first_name": "PATTI",
        "middle_name": "C",
        "credential": "APRN BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00027300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northfield, NJ

Sources for this page

Verify at the official NPI Registry.