Active NPI
Lloyd David Wagner, M.D.
- Diagnostic Radiology Physician
- Camden, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 25MA09610500
- Practice address
- 1 Cooper PLZ
Camden, NJ 08103-1461 - Phone
- (888) 499-8779
- NPI assigned
- Feb 14, 2007
- Last updated
- Aug 28, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 12
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | TM2014-0943 | NM | |
| Diagnostic Radiology Physician | 2085R0202X | MD38592 | SC | |
| Diagnostic Radiology Physician | 2085R0202X | MD453925 | PA | |
| Diagnostic Radiology Physician | 2085R0202X | MD.MD.60512260 | WA | |
| Diagnostic Radiology Physician | 2085R0202X | 164449 | NY | |
| Diagnostic Radiology Physician | 2085R0202X | 036136834 | IL | |
| Diagnostic Radiology Physician | 2085R0202X | 53879 | CT | |
| Diagnostic Radiology Physician | 2085R0202X | 2015016614 | MO | |
| Diagnostic Radiology Physician | 2085R0202X | G70226 | CA | |
| Diagnostic Radiology Physician | 2085R0202X | 2015-00267 | NC | |
| Diagnostic Radiology Physician | 2085R0202X | 25MA09610500 | NJ | Primary |
| Diagnostic Radiology Physician | 2085R0202X | 01074785A | IN |
Addresses
Primary practice location
1 Cooper PLZ
Camden, NJ 08103-1461
Mailing address
1 Federal St Ste 200
Camden, NJ 08103-1088
Phone (848) 288-6935
Other practice location 1
5501 Old York Rd
Philadelphia, PA 19141-3018
Phone (215) 456-6200
Other practice location 2
1014 Oswegatchie Trail Rd
Star Lake, NY 13690-3143
Phone (315) 848-3351
Other practice location 3
3330 W 177th St Ste 1D
Hazel Crest, IL 60429-2185
Phone (708) 799-4940
Other practice location 4
457 Lake Cook Rd
Deerfield, IL 60015-5202
Phone (847) 291-9321
Other practice location 5
1959 NE Pacific St
Seattle, WA 98195-0001
Phone (206) 520-5000
Other practice location 6
28 Crescent St
Middletown, CT 06457-3654
Phone (860) 358-6000
Other practice location 7
3838 N Main St Ste 1A
Mishawaka, IN 46545-3100
Phone (574) 257-4674
Other practice location 8
2560 Samaritan Dr
Las Cruces, NM 88001-1170
Phone (575) 800-3868
Other practice location 9
125 Wamsutta Mill Rd Ste C
Morganton, NC 28655-5522
Phone (828) 430-3511
Other practice location 10
4 Carriage Ln Ste 108
Charleston, SC 29407-6048
Phone (828) 430-3511
Other practice location 11
6000 Hospital Dr
Hannibal, MO 63401-6887
Phone (573) 248-5300
Other practice location 12
223 24th St
Santa Monica, CA 90402-2515
Phone (952) 595-1100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01074785A | Other | IN | INDIANA LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, NY, AZ, IL, TN, MO, IN, WI, FL, OH, PA, KS, GA, NJ, NC, SC, OR, TX, NV, MN, IA, MS, LA, KY, OK, AL, NH, AR, VA, HI, CO, WA, MI, NM, CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 35
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
Santa Monica, CA 90402
Phone (601) 376-8206
1 Clara Maass Dr
Belleville, NJ 07109-3550
Phone (973) 450-2000
100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 375-3261
1000 Rush Dr
Salida, CO 81201-9627
Phone (719) 530-2200
1005 Mar Walt Dr
Fort Walton Beach, FL 32547-6707
Phone (850) 863-8150
1014 Oswegatchie Trail Rd
Star Lake, NY 13690-3143
Phone (315) 848-3351
1020 Crosspointe Dr
Suite 103
Naples, FL 34110-0918
Phone (239) 598-0035
11903 Panama City Beach Pkwy
A
Panama City Beach, FL 32407-2605
Phone (850) 253-0189
16130 Ventura Blvd
Suite 100
Encino, CA 91436-2517
Phone (818) 933-2020
163 River Oaks Dr
Suite 201
Canton, MS 39046-5324
Phone (601) 496-1000
1821 W Olive Ave
Burbank, CA 91506-2435
Phone (818) 841-8880
214 King St
Ogdensburg, NY 13669-1142
Phone (315) 393-3600
2200 N Section St
Sullivan, IN 47882-7523
Phone (812) 268-4311
223 24TH St
Santa Monica, CA 90402-2515
Phone (877) 848-1457
224 E Main St
Springville, NY 14141-1443
Phone 71659228711202
238 S Congress St
Rushville, IL 62681-1465
Phone (217) 322-5296
25395 Hancock Ave
Suite 110
Murrieta, CA 92562-9054
Phone (951) 696-4230
2550 Samaritan Dr
Las Cruces, NM 88001-1170
Phone (800) 421-8274
2560 Samaritan Dr
Las Cruces, NM 88001-1170
Phone (575) 800-3868
2601 W Alameda Ave
Bubank, CA 91505-4810
Phone (818) 843-7462
2679 Zoe Ave
Huntington Park, CA 90255-4144
Phone (323) 584-3333
2705 Loma Vista Rd
Suite 100
Ventura, CA 93003-1595
Phone (805) 988-0616
2708 E Willow St
Signal Hill, CA 90755-2217
Phone (562) 216-5120
2950 Sycamore Dr
Simi Valley, CA 93065-1210
Phone (805) 357-0067
31775 De Portola Rd
Temecula, CA 92592-2742
Phone (951) 238-6070
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15730 | NV | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| 53879 | CT | MD | Diagnostic Radiology Physician |
| 25MA09610500 | NJ | MD | Diagnostic Radiology Physician |
| TM2014-0943 | NM | MD | Diagnostic Radiology Physician |
| 164449 | NY | MD | Diagnostic Radiology Physician |
| MD453925 | PA | MD | Diagnostic Radiology Physician |
Practice roles (60 of 226)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Proscan NCH Imaging LLC | Diagnostic Radiology | Current | Accepting new patients |
| Schuyler County Hospital District | Current | Accepting new patients | |
| Scranton Hospitalist Physician Services LLC | Diagnostic Radiology | Current | Accepting new patients |
| LCM Imaging Inc | Diagnostic Radiology | Current | Accepting new patients |
| Maui Diagnostic Imaging LLC | Diagnostic Radiology | Current | Accepting new patients |
| One Step Diagnostic III, L.P. | Current | Accepting new patients | |
| Stat Portable X-Ray Inc | Current | Accepting new patients | |
| Kan-Di-Ki LLC | Current | Accepting new patients | |
| West Virginia Radiology Associates PC | Diagnostic Radiology | Current | Accepting new patients |
| Dubois Regional Medical Center | Diagnostic Radiology | Current | Accepting new patients |
| Round Rock Imaging LLC | Current | Accepting new patients | |
| Amboy Medical Practice PC | Diagnostic Radiology | Current | Accepting new patients |
| Cal Devon Urgent Care Inc | Diagnostic Radiology | Current | Accepting new patients |
| Medical Technology Transfer Corporation | Current | Accepting new patients | |
| Valdosta Family Medicine Associates, P.C. | Family Medicine | Current | Accepting new patients |
| Beverly Radiology Medical Group III | Diagnostic Radiology | Current | Accepting new patients |
| Kan-Di-Ki LLC | Current | Accepting new patients | |
| Covenant Pathology Associates, PC | Diagnostic Radiology | Current | Accepting new patients |
| Memphis Physicians Radiological Group PC | Diagnostic Radiology | Current | Accepting new patients |
| Mississippi State Hospital | Current | Accepting new patients | |
| Trumbull Radiologists Inc | Diagnostic Radiology | Current | Accepting new patients |
| Ancillary Services of Practice Associates PA | Diagnostic Radiology | Current | Accepting new patients |
| State of Mississippi - University of Mississippi Medical Center | Current | Accepting new patients | |
| St Lawrence Radiology Assoc PC | Diagnostic Radiology | Current | Accepting new patients |
| Mississippi Hma Hospitalists, LLC | Diagnostic Radiology | Current | Accepting new patients |
| Allied Mobile Imaging, LLC | Current | Accepting new patients | |
| Central New York Brain & Spine Neurosurgery PLLC | Current | Accepting new patients | |
| Preferred Imaging of Mesquite LLC | Diagnostic Radiology | Current | Accepting new patients |
| County of Clay | Current | Accepting new patients | |
| Kan-Di-Ki LLC | Current | Accepting new patients | |
| Mantro Mobile Imaging LLC | Current | Accepting new patients | |
| Schuyler County Hospital District | Current | Accepting new patients | |
| Preferred Imaging of McKinney, LLC | Diagnostic Radiology | Current | Accepting new patients |
| Preferred Open MRI, LLC | Diagnostic Radiology | Current | Accepting new patients |
| Medical Technology Transfer Corporation | Current | Accepting new patients | |
| Imaging Center of West Palm Beach LLC | Current | Accepting new patients | |
| J-Preet Inc | Current | Accepting new patients | |
| Proscan Radiology Northern Kentucky, LLC | Diagnostic Radiology | Current | Accepting new patients |
| State of Mississippi - University of Mississippi Medical Center | Current | Accepting new patients | |
| Quimson Development LLC | Current | Accepting new patients | |
| Shores Diagnostic LLC | Current | Accepting new patients | |
| Clifton-Fine Healthcare Corporation | Family Medicine | Current | Accepting new patients |
| Owensboro Health Medical Group Inc | Current | Accepting new patients | |
| County of Clay | Current | Accepting new patients | |
| Mobile Images Acquisition, LLC | Current | Accepting new patients | |
| Ultra Healthcare Services, Inc | Current | Accepting new patients | |
| Peace Health Partners, PC | Diagnostic Radiology | Current | Accepting new patients |
| O C Mobile Imaging | Diagnostic Radiology | Current | Accepting new patients |
| Medical Imaging Specialist in Inc | Current | Accepting new patients | |
| Bertrand Chaffee Hospital | Current | Accepting new patients | |
| 90 Minute Diagnostics LLC | Diagnostic Radiology | Current | Accepting new patients |
| Schuylkill Open MRI Inc | Current | Accepting new patients | |
| KND Development 59 LLC | Current | Accepting new patients | |
| National Mobile X-Ray LLC | Current | Accepting new patients | |
| Owensboro Health Medical Group Inc | Current | Accepting new patients | |
| Mobile X-Ray of Austin Inc | Current | Accepting new patients | |
| Washington Physician Services | Family Medicine | Current | Accepting new patients |
| Mobile Visions Inc | Current | Accepting new patients | |
| Vpa PC | Family Medicine | Current | Accepting new patients |
| Quality Medical Imaging of Washington Inc | Current | Accepting new patients |
Locations (25 of 214)
4370 W Main St
Dothan, AL 36305
Phone (256) 332-1611
623 N 9th St
#40
Augusta, AR 72006
1530 N Church St
#55
Jonesboro, AR 72401
Phone (870) 802-3586
4915 E Baseline Rd
Ste 116
Gilbert, AZ 85234
Phone (480) 354-9200
2538 E University Dr
Ste F220
Phoenix, AZ 85034
Phone (602) 281-4221
7776 S Pointe Pkwy W
Ste 150
Phoenix, AZ 85044
Phone (602) 281-4225
7776 S Pointe Pkwy W
Ste 150A
Phoenix, AZ 85044
Phone 8007868015 ext. 76191
2501 E Southern Ave
Ste 811
Tempe, AZ 85282
Phone (480) 820-2021
7717 N Hartman Ln
Tucson, AZ 85743
Phone (520) 744-6121
11510 S Fortuna Rd
Ste A
Yuma, AZ 85367
Phone (928) 342-7046
18523 Corwin Rd
Ste J
Apple Valley, CA 92307
Phone (760) 242-4444
2301 Bahamas Dr
Bakersfield, CA 93309
3838 San Dimas St
Ste A120
Bakersfield, CA 93301
Phone (661) 328-9600
9330 Stockdale Hwy
Ste 100
Bakersfield, CA 93311
Phone (661) 325-6800
8750 Wilshire Blvd
Ste 100
Beverly Hills, CA 90211
Phone (310) 689-3100
2601 W Alameda Ave
Ste 101
Burbank, CA 91505
Phone (818) 843-7462
2820 N Ontario St
Burbank, CA 91504
Phone (818) 480-9100
801 S Main St
Ste 101
Corona, CA 92882
Phone (951) 682-1099
801 S Main St
Ste 205
Corona, CA 92882
Phone (951) 351-1025
16130 Ventura Blvd
Ste 100
Encino, CA 91436
Phone (818) 933-2020
6107 N Fresno St
Ste 101
Fresno, CA 93710
Phone (559) 435-4433
9191 Westminster Ave
Ste 105
Garden Grove, CA 92844
Phone (714) 583-6314
250 S 12th Ave
Hanford, CA 93230
Phone (559) 295-2450
2679 Zoe Ave
Huntington Park, CA 90255
Phone (323) 584-3333
11360 Mountain View Ave
Ste C
Loma Linda, CA 92354
Phone (909) 478-3300
Interoperability endpoints
- https://api.platform.athenahealth.com/18762/brand/1/csg/1/fhir/r4
- https://fhir.yourcareuniverse.net/tenant/a7b918c3-56d9-410c-bec6-e3d86fde3f92
- https://fhir4.healow.com/fhir/r4/CHFDAA
- lloyd.wagner.1@11356.direct.athenahealth.com
- lloyd.wagner.1@21123.direct.athenahealth.com
- lloyd.wagner@direct.bayonnemedicalcenter.md
- lloydwagner@asjh.medalliesdirect.net
- lwagner219384@ummc.direct-ci.com
Organizations & group practices 270
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba AMG Radiology
- Diagnostic Radiology Physician
- Morristown, NJ
- NPI 1144858408
CA
-
- General Acute Care Hospital
- Springville, NY
- NPI 1275553521
-
- Diagnostic Radiology Physician
- Los Angeles, CA
- NPI 1962457812
NY
-
dba Clifton-Fine Hospital
- Rural Acute Care Hospital
- Star Lake, NY
- NPI 1235184649
Family Medicine
-
- Diagnostic Radiology Physician
- Sullivan, IN
- NPI 1891193314
-
dba Penn Highlands Dubois Radiology/Radiation Oncology
- Diagnostic Radiology Physician
- Du Bois, PA
- NPI 1093812406
-
dba Highlands Hospital Physicians
- Family Medicine Physician
- Connellsville, PA
- NPI 1447443957
-
dba Paris Community Hospital
- Critical Access Hospital
- Paris, IL
- NPI 1679502322
-
- Hospitalist Physician
- Jackson, MS
- NPI 1154608883
CA, Diagnostic Radiology
Hospital & facility affiliations 12
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Mount Nittany Pain Center
- Pain Clinic/Center
- State College, PA
- NPI 1104991801
Hospital
-
- General Acute Care Hospital
- State College, PA
- NPI 1730173154
-
dba Mount Nittany Surgical Center
- Ambulatory Surgical Clinic/Center
- State College, PA
- NPI 1780750620
Hospital
-
- Ambulatory Surgical Clinic/Center
- State College, PA
- NPI 1780752378
Hospital
-
dba Regional Hospital Surgery Center
- Ambulatory Surgical Clinic/Center
- Scranton, PA
- NPI 1740566595
Hospital
-
dba Regional Hospital of Scranton
- General Acute Care Hospital
- Scranton, PA
- NPI 1881983039
-
- Rehabilitation Hospital
- Brownsville, TX
- NPI 1093712697
Inpatient rehabilitation facility
-
dba Merit Health Madison
- General Acute Care Hospital
- Canton, MS
- NPI 1194770404
-
- General Acute Care Hospital
- Las Cruces, NM
- NPI 1760020044
-
dba Wilkes Barre General Hospital
- Clinic/Center
- Wilkes Barre, PA
- NPI 1053554378
Hospital
-
dba Wilkes Barre General Hospital
- General Acute Care Hospital
- Wilkes Barre, PA
- NPI 1255585303
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787875200000",
"number": "1124161872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 FEDERAL ST STE 200",
"city": "CAMDEN",
"state": "NJ",
"postal_code": "081031088",
"telephone_number": "848-288-6935"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 COOPER PLZ",
"city": "CAMDEN",
"state": "NJ",
"postal_code": "081031461",
"telephone_number": "888-499-8779"
}
],
"practiceLocations": [
{
"address_1": "5501 Old York Rd",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191413018",
"country_code": "US",
"telephone_number": "215-456-6200",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1014 Oswegatchie Trail Rd",
"address_purpose": "LOCATION",
"city": "Star Lake",
"state": "NY",
"postal_code": "136903143",
"country_code": "US",
"telephone_number": "315-848-3351",
"fax_number": "315-848-3285",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3330 W 177th St Ste 1D",
"address_purpose": "LOCATION",
"city": "Hazel Crest",
"state": "IL",
"postal_code": "604292185",
"country_code": "US",
"telephone_number": "708-799-4940",
"fax_number": "708-799-0641",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "457 Lake Cook Rd",
"address_purpose": "LOCATION",
"city": "Deerfield",
"state": "IL",
"postal_code": "600155202",
"country_code": "US",
"telephone_number": "847-291-9321",
"fax_number": "847-291-9362",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1959 NE Pacific St",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981950001",
"country_code": "US",
"telephone_number": "206-520-5000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "28 Crescent St",
"address_purpose": "LOCATION",
"city": "Middletown",
"state": "CT",
"postal_code": "064573654",
"country_code": "US",
"telephone_number": "860-358-6000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3838 N Main St Ste 1A",
"address_purpose": "LOCATION",
"city": "Mishawaka",
"state": "IN",
"postal_code": "465453100",
"country_code": "US",
"telephone_number": "574-257-4674",
"fax_number": "574-257-0549",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2560 Samaritan Dr",
"address_purpose": "LOCATION",
"city": "Las Cruces",
"state": "NM",
"postal_code": "880011170",
"country_code": "US",
"telephone_number": "575-800-3868",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "125 Wamsutta Mill Rd Ste C",
"address_purpose": "LOCATION",
"city": "Morganton",
"state": "NC",
"postal_code": "286555522",
"country_code": "US",
"telephone_number": "828-430-3511",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4 Carriage Ln Ste 108",
"address_purpose": "LOCATION",
"city": "Charleston",
"state": "SC",
"postal_code": "294076048",
"country_code": "US",
"telephone_number": "828-430-3511",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6000 Hospital Dr",
"address_purpose": "LOCATION",
"city": "Hannibal",
"state": "MO",
"postal_code": "634016887",
"country_code": "US",
"telephone_number": "573-248-5300",
"fax_number": "573-248-5302",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "223 24th St",
"address_purpose": "LOCATION",
"city": "Santa Monica",
"state": "CA",
"postal_code": "904022515",
"country_code": "US",
"telephone_number": "952-595-1100",
"fax_number": "612-294-4903",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WAGNER",
"first_name": "LLOYD",
"middle_name": "DAVID",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-14",
"last_updated": "2026-08-28",
"certification_date": "2026-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NM",
"license": "TM2014-0943",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "SC",
"license": "MD38592",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "PA",
"license": "MD453925",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "WA",
"license": "MD.MD.60512260",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NY",
"license": "164449",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IL",
"license": "036136834",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CT",
"license": "53879",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MO",
"license": "2015016614",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "G70226",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NC",
"license": "2015-00267",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NJ",
"license": "25MA09610500",
"primary": true
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IN",
"license": "01074785A",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIANA LICENSE",
"identifier": "01074785A",
"state": "IN"
}
],
"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 Aug 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.