Organization Active NPI

Reconstructive Orthopedics, P.a.

  • Orthopaedic Surgery Physician
  • Medford, NJ
National Provider Identifier
1053718882
Registry record updated Apr 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
RECONSTRUCTIVE ORTHOPEDICS, P.A.
Practice address
131 Route 70
Medford, NJ 08055
Phone
(609) 267-9400
Fax
(609) 267-9457
NPI assigned
Nov 21, 2014
Last updated
Apr 24, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
RECONSTRUCTIVE ORTHOPEDICS, P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 24, 2018

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

Authorized official

Name
Melonie Garron
Title
Director of Operations
Phone
(609) 267-9400

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X

Addresses

Primary practice location

131 Route 70
Medford, NJ 08055

Mailing address

4 Eves Dr # a
Suite 100
Marlton, NJ 08053-3195
Phone (609) 267-9400

Other practice location 1

773 E Route 70
Building E-100
Marlton, NJ 08053-2362
Phone (609) 267-9400

National Provider Directory

National Provider Directory
Part of
Reconstructive Orthopedics

Locations

4 Eves Dr
Ste A100
Marlton, NJ 08053
Phone (810) 790-4701

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1416528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524528000000",
    "number": "1053718882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 EVES DR # A",
            "address_2": "SUITE 100",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533195",
            "telephone_number": "609-267-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 ROUTE 70",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "08055",
            "telephone_number": "609-267-9400",
            "fax_number": "609-267-9457"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "773 E Route 70",
            "address_2": "Building E-100",
            "address_purpose": "LOCATION",
            "city": "Marlton",
            "state": "NJ",
            "postal_code": "080532362",
            "country_code": "US",
            "telephone_number": "609-267-9400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RECONSTRUCTIVE ORTHOPEDICS, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RECONSTRUCTIVE ORTHOPEDICS, P.A.",
        "enumeration_date": "2014-11-21",
        "last_updated": "2018-04-24",
        "status": "A",
        "authorized_official_last_name": "GARRON",
        "authorized_official_first_name": "MELONIE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "609-267-9400"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2018; 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.