Individual provider Active NPI

Donna Churlin, MD

  • Pediatrics Physician
  • Camden, NJ
National Provider Identifier
1164451340
Registry record updated Sep 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA05656000 Issued in NJ
Practice address
817 Federal Street
Suite 300
Camden, NJ 08103
Phone
(856) 541-5933
Fax
(856) 541-3340
NPI assigned
Jul 1, 2006
Last updated
Sep 2, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA05656000 NJ Primary

Addresses

Primary practice location

817 Federal Street
Suite 300
Camden, NJ 08103

Mailing address

817 Federal Street
Camden, NJ 08103
Phone (856) 541-5933

Other identifiers 1

IdentifierTypeStateIssuer
5246407MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA05656000NJMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283385600000",
    "number": "1164451340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 FEDERAL STREET",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "08103",
            "telephone_number": "856-541-5933",
            "fax_number": "856-541-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 FEDERAL STREET",
            "address_2": "SUITE 300",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "08103",
            "telephone_number": "856-541-5933",
            "fax_number": "856-541-3340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURLIN",
        "first_name": "DONNA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-01",
        "last_updated": "2010-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA05656000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5246407",
            "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 Sep 2, 2010; 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.