Sparta Gastroenterology LLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

25MA065097 Issued in NJ

Legal business name

SPARTA GASTROENTEROLOGY LLC

Practice address

376 Lafayette Rd
Suite 101
Sparta, NJ 07871

Phone

(973) 579-3174

Fax

(973) 579-2961

NPI assigned

Aug 29, 2007

Organization subpart

No

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

Authorized official

Name

Dmitry Mysh, MD

Title

MD Owner

Phone

(973) 579-3174

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• David C Mueller, DPM

  • Podiatrist
  • Sparta, NJ
  • NPI 1265428965
  NPD (past)

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1245424696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "376 LAFAYETTE RD",
            "address_2": "SUITE 101",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078713560",
            "telephone_number": "973-579-3174",
            "fax_number": "973-579-2961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "376 LAFAYETTE RD",
            "address_2": "SUITE 101",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "07871",
            "telephone_number": "973-579-3174",
            "fax_number": "973-579-2961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARTA GASTROENTEROLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "MYSH",
        "authorized_official_first_name": "DMITRY",
        "authorized_official_title_or_position": "MD OWNER",
        "authorized_official_telephone_number": "973-579-3174",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "25MA065097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8503206",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sparta Chiropractic and Wellness Center, LLC
• Sparta Dental Arts LLC
• Sparta Dental Associates
• Sparta Dental Designs
• Sparta Fit for Life, LLC
• Sparta Medical Associates, P.a.
• Sparta Orthopedic & Sports Physical Therapy LLC
• Sparta Pediatrics, LLC
• Sparta Pharmacy
• Sparta Pharmacy Services

• Gastroenterology Physician in Sparta, NJ
• Providers in Sparta, NJ by specialty
• Gastroenterology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; 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.