Individual provider Active NPI

Jessica Anne Marie Gunn, A.P.N

  • Nurse Practitioner
  • Medford, NJ
National Provider Identifier
1962820209
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ00490600 Issued in NJ
Practice address
21 Ohio TRL
Medford, NJ 08055-8931
Phone
(856) 308-7975
NPI assigned
Apr 3, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NR15937400 NJ
Nurse Practitioner 363L00000X 26NJ00490600 NJ Primary
Family Nurse Practitioner 363LF0000X 26NJ00490600 NJ

Addresses

Primary practice location

21 Ohio TRL
Medford, NJ 08055-8931

Mailing address

21 Ohio TRL
Medford, NJ 08055-8931
Phone (856) 308-7975

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jgunn14227@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140730002550 NJ Practitioner - Nurse Practitioner 9133345960 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NR15937400NJMDNurse Practitioner
26NJ00490600NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physician Associates of South Jersey P C CurrentSince Apr 1, 2022 Accepting new patients
Virtua Medical Group, PA Nurse Practitioner CurrentSince May 1, 2016 Accepting new patients
Ra Pain Services PA CurrentSince Jan 26, 2015 Accepting new patients
Virtua Medical Group, PA Current Accepting new patients

Locations

100 Townsend Ave
Berlin, NJ 08009
Phone (856) 322-3000

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

401 Young Ave
Ste 380A
Moorestown, NJ 08057
Phone (856) 291-8650

218A Sunset Rd
Willingboro, NJ 08046
Phone (609) 835-2900

218 Sunset Rd
Willingboro, NJ 08046
Phone (609) 835-2900

Organizations & group practices 4

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": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1962820209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 OHIO TRL",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080558931",
            "telephone_number": "856-308-7975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 OHIO TRL",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080558931",
            "telephone_number": "856-308-7975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNN",
        "first_name": "JESSICA",
        "middle_name": "ANNE MARIE",
        "name_prefix": "Mrs.",
        "credential": "A.P.N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-03",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NR15937400",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00490600",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00490600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgunn14227@directvirtua.org",
            "affiliation": "N",
            "address_1": "401 Young Ave Ste 380A",
            "city": "Moorestown",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080573130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Medford, NJ

Sources for this page

Verify at the official NPI Registry.