Active NPI
Reconstructive Orthopedics, P.a.
- Orthopaedic Surgery Physician
- Medford, NJ
National Provider Identifier
1053718882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- 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, 2018
- Organization subpart
- Yes
- Parent organization
- RECONSTRUCTIVE ORTHOPEDICS, P.A.
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | Primary | ||
| Physical Medicine & Rehabilitation Physician | 208100000X | |||
| Pain Medicine (Physical Medicine & Rehabilitation) Physician | 2081P2900X | |||
| Physician Assistant | 363A00000X | |||
| Surgical Physician Assistant | 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.
-
- Orthopaedic Surgery Physician
- Medford, NJ
- NPI 1124526421
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.