Organization Active NPI

Reliance Medical Group, LLC

  • Family Medicine Physician
  • Atlantic City, NJ
National Provider Identifier
1154720613
Registry record updated Aug 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA07552100 Issued in NJ
Legal business name
RELIANCE MEDICAL GROUP, LLC
Practice address
1325 Baltic Ave
Atlantic City, NJ 08401-4516
Phone
(609) 441-0723
Fax
(609) 441-0953
NPI assigned
Aug 20, 2014
Last updated
Aug 20, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2014

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

Authorized official

Name
Jon M Regis, MDNPI 1508880717
Title
Owner
Phone
(609) 272-0655

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 25MA07552100 NJ Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 25MA04388900 NJ
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 25MA03906000 NJ

Addresses

Primary practice location

1325 Baltic Ave
Atlantic City, NJ 08401-4516

Mailing address

22 N Franklin Blvd
2ND Floor
Pleasantville, NJ 08232-2547
Phone (609) 272-0655

National Provider Directory

National Provider Directory

Locations

1401 Atlantic Ave
Atlantic City, NJ 08401
Phone (609) 441-7088

1401 Atlantic Ave
Ste 2400
Atlantic City, NJ 08401
Phone (609) 345-6974

29 S New York Ave
Atlantic City, NJ 08401
Phone (609) 345-6335

4401 Ventnor Ave
Ste 3
Atlantic City, NJ 08401
Phone (609) 345-2050

3069 English Creek Ave
Ste 203
Egg Hbr Twp, NJ 08234
Phone (609) 377-8516

1161 Route 50
Ste C
Mays Landing, NJ 08330
Phone (609) 625-8911

22 N Franklin Blvd
Fl 1
Pleasantville, NJ 08232
Phone (609) 272-0655

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1408492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408492800000",
    "number": "1154720613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 N FRANKLIN BLVD",
            "address_2": "2ND FLOOR",
            "city": "PLEASANTVILLE",
            "state": "NJ",
            "postal_code": "082322547",
            "telephone_number": "609-272-0655",
            "fax_number": "609-272-9317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 BALTIC AVE",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084014516",
            "telephone_number": "609-441-0723",
            "fax_number": "609-441-0953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELIANCE MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-20",
        "last_updated": "2014-08-20",
        "status": "A",
        "authorized_official_last_name": "REGIS",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-272-0655",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA07552100",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA04388900",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA03906000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantic City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; 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.