NPIMap

Organization Active NPI

Lourdes Medical Associates, PA

  • Vascular Surgery Physician
  • Camden, NJ
National Provider Identifier
1104096668
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
25MA06038700 Issued in NJ
Legal business name
LOURDES MEDICAL ASSOCIATES, PA
Practice address
1601 Haddon Ave
Camden, NJ 08103-3109
Phone
(856) 757-3840
Fax
(856) 757-3519
NPI assigned
Mar 11, 2008
Organization subpart
Yes
Parent organization
LOURDES MEDICAL ASSOCIATES, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Authorized official

Name
Ms. Linda Rosenson
Title
Cfo
Phone
(856) 796-9200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X 25MA06038700 NJ Primary

Addresses

Primary practice location

1601 Haddon Ave
Camden, NJ 08103-3109

Mailing address

500 Grove St
Suite 100
Haddon Heights, NJ 08035-1702
Phone (856) 796-9200

Other identifiers 1

IdentifierTypeStateIssuer
6535704MedicaidNJ

Other names 1

  • LMA Center for Organ Transplantation Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Laurdes Medical Assoc P65 organizations share this tax ID, including this one
Part of
Laurdes Medical Assoc P

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

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": "1205193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1104096668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 GROVE ST",
            "address_2": "SUITE 100",
            "city": "HADDON HEIGHTS",
            "state": "NJ",
            "postal_code": "080351702",
            "telephone_number": "856-796-9200",
            "fax_number": "856-310-5603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 HADDON AVE",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081033109",
            "telephone_number": "856-757-3840",
            "fax_number": "856-757-3519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOURDES MEDICAL ASSOCIATES, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOURDES MEDICAL ASSOCIATES, PA",
        "enumeration_date": "2008-03-11",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "ROSENSON",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "856-796-9200",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "NJ",
            "license": "25MA06038700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6535704",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LMA Center for Organ Transplantation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Camden, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.