Liberty Corner Surgical Center at Marlton LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

LIBERTY CORNER SURGICAL CENTER AT MARLTON LLC

Practice address

95 Marlton Pike West
Marlton, NJ 08053

Phone

(973) 871-1229

NPI assigned

Apr 9, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Richard Scott Jr., M.D.

Title

Ceo

Phone

(973) 656-2840

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Ambulatory surgical center certification: CCN 31C0001346

Legal name

LIBERTY CORNER SURGICAL CENTER AT MARLTON LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jul 15, 2021

Last certification

Jul 15, 2021

Ownership / control type

Proprietary

Facility address

95 Marlton Pike West
Marlton, NJ 08053

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

CLIA laboratory certificates

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554854400000",
    "number": "1235692120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 ALLEN RD",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079202976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 MARLTON PIKE WEST",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "08053",
            "telephone_number": "973-871-1229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY CORNER SURGICAL CENTER AT MARLTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-09",
        "last_updated": "2019-04-10",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "973-656-2840",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rjenco@ivirma.com",
            "affiliation": "N",
            "address_1": "767 Route 70 E Ste B101",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080532345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bryan H Levey, MD
• Gary H. Levin, MD
• Stacy Lewin, MD
• Steven Liakos, D.O.
• Jennifer Liang, PA-C
• Lice Lifters Marlton NJ
• Kristin Elizabeth Lieberman, M.A.
• Liebman Wellness Center, P.C.
• Jesse R. Liebman, DC.
• Justin Alec Liebman

• Ambulatory Surgical Clinic/Center in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Ambulatory Surgical Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.