NPIMap

Organization Active NPI

Summit Health-Virtua Inc., Crna

  • Certified Registered Nurse Anesthetist
  • Marlton, NJ
National Provider Identifier
1154477586
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
SUMMIT HEALTH-VIRTUA INC., CRNA
Practice address
90 Brick Rd
Marlton, NJ 08053-2177
Phone
(856) 355-6057
Fax
(856) 988-6270
NPI assigned
Jan 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. James Dwyer, D.O
Title
Executive Vice President
Phone
(856) 355-0007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

90 Brick Rd
Marlton, NJ 08053-2177

Mailing address

5 Eves Dr
Suite 120a
Marlton, NJ 08053-3135
Phone (856) 355-0344

National Provider Directory

National Provider Directory
Tax ID family
Summit Health-Virtua Inc Crna2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5 Eves Dr
Ste 120A
Marlton, NJ 08053

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154477586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 EVES DR",
            "address_2": "SUITE 120A",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533135",
            "telephone_number": "856-355-0344",
            "fax_number": "856-355-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 BRICK RD",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532177",
            "telephone_number": "856-355-6057",
            "fax_number": "856-988-6270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT HEALTH-VIRTUA INC., CRNA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DWYER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "856-355-0007",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.