NPIMap

Organization Active NPI

Lourdes Medical Associates, PA

  • Family Medicine Physician
  • Hainesport, NJ
National Provider Identifier
1134511652
Registry record updated Feb 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LOURDES MEDICAL ASSOCIATES, PA
Practice address
300 Creek Crossing Blvd
Hainesport, NJ 08036-2767
Phone
(609) 702-0014
Fax
(609) 702-7225
NPI assigned
Feb 20, 2015
Organization subpart
Yes
Parent organization
LOURDES MEDICAL ASSOCIATES, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 20, 2015

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

Authorized official

Name
Dr. Steven Fox, MD
Title
President
Phone
(856) 796-9200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X NJ Primary

Addresses

Primary practice location

300 Creek Crossing Blvd
Hainesport, NJ 08036-2767

Mailing address

500 Grove St
Suite 100
Haddon Heights, NJ 08035-1761
Phone (856) 796-9200

Other identifiers 1

IdentifierTypeStateIssuer
6535704MedicaidNJ

Other names 1

  • Lourdes Medical Associates Hainsport Family Medicine 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 20

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

View all 20

Locations

300 Creek Crossing Blvd
Hainesport, NJ 08036
Phone (609) 702-0014

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": "1424390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424390400000",
    "number": "1134511652",
    "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": "080351761",
            "telephone_number": "856-796-9200",
            "fax_number": "856-796-9397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CREEK CROSSING BLVD",
            "city": "HAINESPORT",
            "state": "NJ",
            "postal_code": "080362767",
            "telephone_number": "609-702-0014",
            "fax_number": "609-702-7225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOURDES MEDICAL ASSOCIATES, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOURDES MEDICAL ASSOCIATES, PA",
        "enumeration_date": "2015-02-20",
        "last_updated": "2015-02-20",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-796-9200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6535704",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lourdes Medical Associates Hainsport Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hainesport, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2015; 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.