NPIMap

Organization Active NPI

Primary Care Partners LLC

Doing business as Pediatric and Adolescent Center- Primary Care Partners Affiliate

  • Pediatrics Physician
  • Ledgewood, NJ
National Provider Identifier
1174927305
Registry record updated Oct 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PRIMARY CARE PARTNERS LLC
Doing business as
Pediatric and Adolescent Center- Primary Care Partners Affiliate
Practice address
1911 US Highway 46
Ledgewood, NJ 07852-9758
Phone
(973) 347-8500
Fax
(973) 347-7320
NPI assigned
Oct 17, 2014
Last updated
Oct 17, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
PRIMARY CARE PARTNERS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 17, 2014

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

Authorized official

Name
Dr. David J Shulkin, MD
Title
Ceo
Phone
(856) 782-3300

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary
Pediatric Adolescent Medicine Physician 2080A0000X
Pediatric Allergy/Immunology Physician 2080P0201X

Addresses

Primary practice location

1911 US Highway 46
Ledgewood, NJ 07852-9758

Mailing address

PO Box 2403
Voorhees, NJ 08043-6403
Phone (856) 782-3300

Other names 1

  • Pediatric and Adolescent Center- Primary Care Partners Affiliate Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Primary Care Partners LLC44 organizations share this tax ID, including this one
Part of
Primary Care Partners LLC

Other organizations with this tax ID 43

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

View all 43

Locations

1911 US Highway 46
Ledgewood, NJ 07852
Phone (973) 347-8500

NPI Registry JSON

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413504000000",
    "number": "1174927305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2403",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080436403",
            "telephone_number": "856-782-3300",
            "fax_number": "856-504-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 US HIGHWAY 46",
            "city": "LEDGEWOOD",
            "state": "NJ",
            "postal_code": "078529758",
            "telephone_number": "973-347-8500",
            "fax_number": "973-347-7320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE PARTNERS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRIMARY CARE PARTNERS LLC",
        "enumeration_date": "2014-10-17",
        "last_updated": "2014-10-17",
        "status": "A",
        "authorized_official_last_name": "SHULKIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "856-782-3300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric and Adolescent Center- Primary Care Partners Affiliate",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ledgewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.