NPIMap

Organization Active NPI

Atlanticare Physician Group PA

Doing business as AtlantiCare Urgent Care- Galloway Township

  • Non-Pharmacy Dispensing Site
  • Galloway, NJ
National Provider Identifier
1083000707
Registry record updated Apr 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
25MB05380400 Issued in NJ
Legal business name
ATLANTICARE PHYSICIAN GROUP PA
Doing business as
AtlantiCare Urgent Care- Galloway Township
Practice address
110 E Jimmie Leeds Rd
Galloway, NJ 08205-9508
Phone
(609) 748-2100
NPI assigned
Apr 9, 2015
Last updated
Apr 29, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDVANTX, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 29, 2015

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

Authorized official

Name
Kenny Heine
Title
VP of Operations
Phone
(858) 964-1506

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X 25MB05380400 NJ Primary

Addresses

Primary practice location

110 E Jimmie Leeds Rd
Galloway, NJ 08205-9508

Mailing address

5626 Oberlin Dr
Suite 110
San Diego, CA 92121-1705

Other names 1

  • AtlantiCare Urgent Care- Galloway Township Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Atlanticare Physician Group PC22 organizations share this tax ID, including this one
Part of
Medvantx Inc

Other organizations with this tax ID 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430265600000",
    "number": "1083000707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E JIMMIE LEEDS RD",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059508",
            "telephone_number": "609-748-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTICARE PHYSICIAN GROUP PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2015-04-09",
        "last_updated": "2015-04-29",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "858-964-1506"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NJ",
            "license": "25MB05380400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AtlantiCare Urgent Care- Galloway Township",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Galloway, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2015; 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.