NPIMap

Organization Active NPI

96TH Street Urgent Care

  • Family Medicine Physician
  • Stone Harbor, NJ
National Provider Identifier
1235359001
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MB72117 Issued in NJ
Legal business name
96TH STREET URGENT CARE
Doing business as
96th street urgent care
Practice address
376 96TH St
Suite # 2
Stone Harbor, NJ 08247-1404
Phone
(609) 368-3500
Fax
(609) 967-0077
NPI assigned
Apr 26, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Tara A Vogdes, DONPI 1386601649
Title
Owner
Phone
(609) 967-0070

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MB72117 NJ Primary

Addresses

Primary practice location

376 96TH St
Suite # 2
Stone Harbor, NJ 08247-1404

Mailing address

376 96TH St
Suite # 2
Stone Harbor, NJ 08247-1404
Phone (609) 368-3500

Other names 1

  • 96th street urgent care Doing business as

National Provider Directory

National Provider Directory

Locations

376 96th St
Ste 2
Stone Harbor, NJ 08247
Phone (609) 368-3500

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235359001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "376 96TH ST",
            "address_2": "SUITE # 2",
            "city": "STONE HARBOR",
            "state": "NJ",
            "postal_code": "082471404",
            "telephone_number": "609-368-3500",
            "fax_number": "609-967-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "376 96TH ST",
            "address_2": "SUITE # 2",
            "city": "STONE HARBOR",
            "state": "NJ",
            "postal_code": "082471404",
            "telephone_number": "609-368-3500",
            "fax_number": "609-967-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "96TH STREET URGENT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VOGDES",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-967-0070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB72117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "96th street urgent care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stone Harbor, NJ

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.