Organization Active NPI

Center City Family Practice, Inc

  • Family Medicine Physician
  • Atlantic City, NJ
National Provider Identifier
1245398957
Registry record updated Oct 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CENTER CITY FAMILY PRACTICE, INC
Practice address
2512 Atlantic Ave
Atlantic City, NJ 08401-6502
Phone
(609) 347-7333
Fax
(609) 347-1632
NPI assigned
Dec 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2010

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

Authorized official

Name
Mrs. Betty Hendrickson
Title
Office Manager
Phone
(609) 347-7333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2512 Atlantic Ave
Atlantic City, NJ 08401-6502

Mailing address

2512 Atlantic Ave
Atlantic City, NJ 08401-6502
Phone (609) 347-7333

Other identifiers 1

IdentifierTypeStateIssuer
5100208MedicaidNJ

National Provider Directory

National Provider Directory

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": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285891200000",
    "number": "1245398957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 ATLANTIC AVE",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084016502",
            "telephone_number": "609-347-7333",
            "fax_number": "609-347-1632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 ATLANTIC AVE",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084016502",
            "telephone_number": "609-347-7333",
            "fax_number": "609-347-1632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER CITY FAMILY PRACTICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2010-10-01",
        "status": "A",
        "authorized_official_last_name": "HENDRICKSON",
        "authorized_official_first_name": "BETTY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "609-347-7333",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5100208",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantic City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2010; 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.