Individual provider Active NPI

Monique Higginbotham, MD

  • Pediatrics Physician
  • Hammonton, NJ
National Provider Identifier
1225006208
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA09157000 Issued in NJ
Practice address
860 S White Horse Pike
Hammonton, NJ 08037-2018
Phone
(609) 567-0200
Fax
(609) 567-1951
NPI assigned
Mar 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD071679L PA
Child Abuse Pediatrics Physician 2080C0008X 25MA09157000 NJ
Pediatrics Physician 208000000X 25MA09157000 NJ Primary

Addresses

Primary practice location

860 S White Horse Pike
Hammonton, NJ 08037-2018

Mailing address

1 N White Horse Pike
Hammonton, NJ 08037-1875
Phone (609) 567-0200

Other practice location 1

42 E Laurel Rd Ste 1100
Stratford, NJ 08084-1354
Phone (856) 566-7036

Other identifiers 2

IdentifierTypeStateIssuer
8297703MedicaidNJ
F82709OtherUPIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201204000429 NJ Practitioner - Pediatric Medicine 0547282691 Reassigns benefits to 1 organization
I20221013002296 TX Practitioner - Pediatric Medicine 0547282691 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD071679LPAMDSpecialist
25MA09157000NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Jersey Family Medical Centers, Inc CurrentSince Nov 16, 2020 Accepting new patients
The Fort Defiance Indian Hospital Board, Incorporation CurrentSince Oct 10, 2022 Accepting new patients
Southern Jersey Family Medical Centers Inc CurrentSince Nov 16, 2020 Accepting new patients
Rowansom Cares Institute Past Accepting new patients
Ventnor Pediatrics Inc. Past Accepting new patients
Atlanticare Regional Medical Center Past Accepting new patients
Rowansom Cares Institute Pediatrics Past Accepting new patients

Locations

1 N White Horse Pike
Hammonton, NJ 08037
Phone (609) 567-0200

860 S White Horse Pike
Hammonton, NJ 08037
Phone (609) 567-0200

65 W Jimmie Leeds Rd
Pomona, NJ 08240
Phone (609) 484-6414

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1225006208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 N WHITE HORSE PIKE",
            "city": "HAMMONTON",
            "state": "NJ",
            "postal_code": "080371875",
            "telephone_number": "609-567-0200",
            "fax_number": "609-567-1169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 S WHITE HORSE PIKE",
            "city": "HAMMONTON",
            "state": "NJ",
            "postal_code": "080372018",
            "telephone_number": "609-567-0200",
            "fax_number": "609-567-1951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "42 E Laurel Rd Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Stratford",
            "state": "NJ",
            "postal_code": "080841354",
            "country_code": "US",
            "telephone_number": "856-566-7036",
            "fax_number": "856-566-6108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HIGGINBOTHAM",
        "first_name": "MONIQUE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD071679L",
            "primary": false
        },
        {
            "code": "2080C0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Child Abuse Pediatrics",
            "state": "NJ",
            "license": "25MA09157000",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA09157000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8297703",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "F82709",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammonton, NJ

Sources for this page

Verify at the official NPI Registry.