Reliance Medical Group, LLC

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

25MA08497400 Issued in NJ

Legal business name

RELIANCE MEDICAL GROUP, LLC

Practice address

4013 Route 9 N
Howell, NJ 07731-4021

Phone

(732) 905-5255

Fax

(732) 905-5266

NPI assigned

Apr 15, 2014

Last updated

Oct 7, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jon M Regis, MDNPI 1508880717

Title

Owner

Phone

(609) 272-0655

Specialties & licenses 3

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jon M Regis, M.D.

  • Obstetrics & Gynecology Physician
  • Northfield, NJ
  • NPI 1508880717
  Authorized official Same address or phone

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475798400000",
    "number": "1104245349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 N FRANKLIN BLVD",
            "address_2": "2ND FLOOR",
            "city": "PLEASANTVILLE",
            "state": "NJ",
            "postal_code": "082322547",
            "telephone_number": "609-272-0655",
            "fax_number": "609-272-9317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4013 ROUTE 9 N",
            "city": "HOWELL",
            "state": "NJ",
            "postal_code": "077314021",
            "telephone_number": "732-905-5255",
            "fax_number": "732-905-5266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELIANCE MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-15",
        "last_updated": "2016-10-07",
        "status": "A",
        "authorized_official_last_name": "REGIS",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-272-0655",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA07164700",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA07968600",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "25MA08497400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Medicine (Internal Medicine) Physician in Howell, NJ
• Providers in Howell, NJ by specialty
• Geriatric Medicine (Internal Medicine) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; 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.