NPIMap

Organization Active NPI

CMC Department of Medicine

  • Internal Medicine Physician
  • Camden, NJ
National Provider Identifier
1104945005
Registry record updated Mar 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CMC DEPARTMENT OF MEDICINE
Practice address
3 Cooper PLZ
Suite 215
Camden, NJ 08103-1438
Phone
(856) 963-2439
NPI assigned
Mar 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2008

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

Authorized official

Name
Mr. Robert McMullen
Title
Evp Managed Care
Phone
(856) 342-2921

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

3 Cooper PLZ
Suite 215
Camden, NJ 08103-1438

Mailing address

3 Cooper PLZ
Suite 502
Camden, NJ 08103-1438
Phone (856) 342-2921

Other identifiers 1

IdentifierTypeStateIssuer
2577992000OtherNJAMERIHLT INT MED GRP#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050104000343 NJ Part B Supplier - Clinic/Group Practice 2163335878 Receives reassigned benefits from 452 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mount Laurel, NJ; Salem, NJ; Mullica Hill, NJ; Pennsville, NJ; Sewell, NJ; Swedesboro, NJ; Voorhees, NJ; West Deptford, NJ…

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

800 Cooper St
Fl 4
Camden, NJ 08102
Phone (856) 342-3040

1030 Kings Hwy N
Ste 310
Cherry Hill, NJ 08034
Phone (856) 667-7266

Practitioners & affiliated clinicians

Practitioners 81

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 81

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205884800000",
    "number": "1104945005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 COOPER PLZ",
            "address_2": "SUITE 502",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031438",
            "telephone_number": "856-342-2921",
            "fax_number": "856-968-8499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 COOPER PLZ",
            "address_2": "SUITE 215",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031438",
            "telephone_number": "856-963-2439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMC DEPARTMENT OF MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2008-03-19",
        "status": "A",
        "authorized_official_last_name": "MCMULLEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "EVP MANAGED CARE",
        "authorized_official_telephone_number": "856-342-2921",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHLT INT MED GRP#",
            "identifier": "2577992000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Mar 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.