South Jersey Medical Associates, LLC

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

Legal business name

SOUTH JERSEY MEDICAL ASSOCIATES, LLC

Practice address

1304 Route 47 Unit Wu-N2ND
Rio Grande, NJ 08242-1399

Phone

(609) 451-1125

Fax

(609) 438-7944

NPI assigned

Sep 29, 2019

Organization subpart

No

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

Authorized official

Name

Jason Christopher Graham, APN-CNPI 1194114454

Title

Co-Owner

Phone

(609) 451-1125

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 2

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

• Jason Christopher Graham, APN-C

  • Family Nurse Practitioner
  • Rio Grande, NJ
  • NPI 1194114454

  Multi-Specialty

  Medicare reassignment NPD Authorized official
• Jamie Bowden, CCMA

  • Case Manager/Care Coordinator
  • Rio Grande, NJ
  • NPI 1053241828
  NPD (past)

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

{
    "created_epoch": "1569715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726099200000",
    "number": "1215588447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 ROUTE ROUTE 47 SOUTH",
            "address_2": "UNIT WU-N - 2ND FLOOR",
            "city": "RIO GRANDE",
            "state": "NJ",
            "postal_code": "08242",
            "telephone_number": "609-451-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 ROUTE 47 UNIT WU-N2ND",
            "city": "RIO GRANDE",
            "state": "NJ",
            "postal_code": "082421399",
            "telephone_number": "609-451-1125",
            "fax_number": "609-438-7944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH JERSEY MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-29",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-05",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "609-451-1125",
        "authorized_official_credential": "APN-C"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0561053",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0697320",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maegan Elisabeth Sharkey, DPT
• Abigail Elizabeth Sheilds, PA
• Gino Sinigaglio, PHARMD
• Robert L Sistler Jr., LSW
• Joanne Smith, CNA
• Shirley Stefanovicz, LPN
• Toby L Stone, DPT
• Kelly A Tallio, D.M.D.
• Roberta-Joy Mary Taylor, LSW
• Nidhi Thaker

• Addiction Medicine (Family Medicine) Physician in Rio Grande, NJ
• Providers in Rio Grande, NJ by specialty
• Addiction Medicine (Family Medicine) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.