Medexpress Urgent Care - New Jersey, Inc.

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

MEDEXPRESS URGENT CARE - NEW JERSEY, INC.

Doing business as

MedExpress Urgent Care - Willingboro

Practice address

4318 Route 130N
Willingboro, NJ 08046-1427

Phone

(609) 871-2045

Fax

(609) 871-2042

NPI assigned

Nov 28, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Timothy G. Bugin

Title

VP of Payor Contracting

Phone

(304) 225-2500

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• MedExpress Urgent Care - Willingboro Doing business as

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

{
    "created_epoch": "1354060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473292800000",
    "number": "1205171501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 CONSOL ENERGY DR",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153176506",
            "telephone_number": "304-225-2500",
            "fax_number": "724-743-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4318 ROUTE 130N",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080461427",
            "telephone_number": "609-871-2045",
            "fax_number": "609-871-2042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDEXPRESS URGENT CARE - NEW JERSEY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-28",
        "last_updated": "2016-09-08",
        "status": "A",
        "authorized_official_last_name": "BUGIN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "VP OF PAYOR CONTRACTING",
        "authorized_official_telephone_number": "304-225-2500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0347116",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedExpress Urgent Care - Willingboro",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pravinkumar K Mashru II
• Brenda Mayo-Ekuma, LPN
• Victoria McCoy, LPN
• Pamela Mechling, DPT
• Medco Health Solutions of Willingboro, LLC (Medco Center for Pharmacotherapeutic Research)
• Lisa Ann Medvetz, MD
• Meek & Humble LLC
• Shivalika Mehan, MD
• Jasmeet Mehta, M.D
• Vittoria Mello, FNP-BC

• Urgent Care Clinic/Center in Willingboro, NJ
• Providers in Willingboro, NJ by specialty
• Urgent Care Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; 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.