Family Practice Medical

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

MB44700 Issued in NJ

Legal business name

FAMILY PRACTICE MEDICAL

Practice address

3814 Church Rd
Mount Laurel, NJ 08054-1106

Phone

(856) 231-9792

NPI assigned

Jan 2, 2007

Organization subpart

No

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

Authorized official

Name

Peggy A Kelly, DO

Title

Office Manager

Phone

(856) 231-9792

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 8

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

• Dorothy Iannaco, APN

  • Family Nurse Practitioner
  • Sewell, NJ
  • NPI 1649269309
  NPD (past)
• Regina Mazzuca, APN-C

  • Adult Health Nurse Practitioner
  • Linwood, NJ
  • NPI 1154404796
  NPD (past)
• Frank P Pettinelli, D.O.

  • Family Medicine Physician
  • Mount Laurel, NJ
  • NPI 1215979307
  NPD (past)
• Joseph N. Ranieri, DO

  • Addiction Medicine (Family Medicine) Physician
  • Sewell, NJ
  • NPI 1851464143
  NPD (past)
• Fran Rosenfeld, NP

  • Adult Health Nurse Practitioner
  • Cherry Hill, NJ
  • NPI 1619079761
  NPD (past)
• Robin D Schaffner, APN-C

  • Nurse Practitioner
  • Audubon, NJ
  • NPI 1396885679
  NPD (past)
• Joseph Arthur White, DO

  • Family Medicine Physician
  • Stratford, NJ
  • NPI 1467539379
  NPD (past)
• Deborah Gondek, D.O.

  • Hospitalist Physician
  • Bryn Mawr, PA
  • NPI 1346234838
  NPD (past)

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194882183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3814 CHURCH RD",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541106",
            "telephone_number": "856-231-9792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3814 CHURCH RD",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541106",
            "telephone_number": "856-231-9792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRACTICE MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "856-231-9792",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "MB44700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Fabii, MS
• Emmanuel Faeflen, MENTAL HEALTH CONSEL
• Jacqueline Fagan
• Samantha Kathleen Fagan, BCBA,LBA
• Kylie Fair, OTR/L
• Faq by Nurse Jessi Consulting, LLC.
• Nicole Farese, IBCLC
• Connor Farley, BCBA
• Janice L. Fauser
• Cindy Faust, LCSW CEAP

• Geriatric Medicine (Family Medicine) Physician in Mount Laurel, NJ
• Providers in Mount Laurel, NJ by specialty
• Geriatric Medicine (Family Medicine) Physician in New Jersey

• 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.