NPIMap

Organization Active NPI

Kimball Medical Center House Staff/Ekg

  • Cardiovascular Disease Physician
  • Lakewood, NJ
National Provider Identifier
1013967348
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
KIMBALL MEDICAL CENTER HOUSE STAFF/EKG
Practice address
600 River Ave
Lakewood, NJ 08701-5237
Phone
(732) 886-4443
Fax
(732) 886-4659
NPI assigned
May 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Anthony Esposito
Title
Director
Phone
(732) 557-7160

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

600 River Ave
Lakewood, NJ 08701-5237

Mailing address

PO Box 6069
Bellmawr, NJ 08099-6069
Phone (732) 557-7160

Other identifiers 1

IdentifierTypeStateIssuer
7997507MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Corporatecare2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

101 2nd St
Lakewood, NJ 08701
Phone (732) 886-4809

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013967348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6069",
            "city": "BELLMAWR",
            "state": "NJ",
            "postal_code": "080996069",
            "telephone_number": "732-557-7160",
            "fax_number": "732-557-7109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 RIVER AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015237",
            "telephone_number": "732-886-4443",
            "fax_number": "732-886-4659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBALL MEDICAL CENTER HOUSE STAFF/EKG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ESPOSITO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "732-557-7160",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7997507",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.