Individual provider Active NPI

Lori C Talbot, MD

  • Family Medicine Physician
  • Bridgeton, NJ
National Provider Identifier
1013930023
Registry record updated Aug 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MAO5305000 Issued in NJ
Practice address
215 Back Neck Road
Bridgeton, NJ 08302
Phone
(856) 451-4414
Fax
(856) 451-2052
NPI assigned
Jul 25, 2006
Last updated
Aug 3, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MAO5305000 NJ Primary

Addresses

Primary practice location

215 Back Neck Road
Bridgeton, NJ 08302

Mailing address

215 Back Neck Rd
Bridgeton, NJ 08302-6834
Phone (856) 451-4414

Other identifiers 1

IdentifierTypeStateIssuer
3615405MedicaidNJ

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040303000179 NJ Practitioner - Family Practice 2769379841 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MAO5305000NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Cumberland Medical Associates PC Family Medicine CurrentSince Jan 1, 2004 Accepting new patients

Locations

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280793600000",
    "number": "1013930023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 BACK NECK RD",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "083026834",
            "telephone_number": "856-451-4414",
            "fax_number": "856-451-2052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 BACK NECK ROAD",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "08302",
            "telephone_number": "856-451-4414",
            "fax_number": "856-451-2052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALBOT",
        "first_name": "LORI",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2010-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MAO5305000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3615405",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, NJ

Sources for this page

Verify at the official NPI Registry.