Vineland Pediatrics PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

VINELAND PEDIATRICS PA

Practice address

1138 E Chestnut Ave #5B
Vineland, NJ 08360-5062

Phone

(856) 692-1108

Fax

(856) 692-2077

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Deborah L McMaster, RN

Title

Office Manager

Phone

(856) 692-1108

Specialties & licenses 1

Addresses

Other identifiers 7

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279238400000",
    "number": "1104937259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1138 E CHESTNUT AVE #5B",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605062",
            "telephone_number": "856-692-1108",
            "fax_number": "856-692-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 E CHESTNUT AVE #5B",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605062",
            "telephone_number": "856-692-1108",
            "fax_number": "856-692-2077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINELAND PEDIATRICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-07-16",
        "status": "A",
        "authorized_official_last_name": "MCMASTER",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "856-692-1108",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH HIPPA",
            "identifier": "0513129001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "679080",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS HEALTH",
            "identifier": "F03778",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON HEALTH",
            "identifier": "1043187",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "E337",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3041",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3394603",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vineland Obstetrical & Gynecologial Professional Association
• Vineland Operating, LLC
• Vineland Operations LLC
• Vineland Operations, LLC
• Vineland Oral Surgeons PA
• Vineland Pharma LLC
• Vipin K Gupta
• Vipin Kumar Gupta , MD PA
• Luis Virella, LCSW, LCADC
• Virtua Medical Group, PA

• Pediatrics Physician in Vineland, NJ
• Providers in Vineland, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.