Individual provider Active NPI

John S Garra, MD

  • Gynecology Physician
  • Collingswood, NJ
National Provider Identifier
1255318390
Registry record updated Jun 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
25MA02158000 Issued in NJ
Practice address
1055 Haddon Ave
Collingswood, NJ 08108-2047
Phone
(856) 854-4524
Fax
(856) 854-8216
NPI assigned
Dec 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 25MA02158000 NJ Primary

Addresses

Primary practice location

1055 Haddon Ave
Collingswood, NJ 08108-2047

Mailing address

500 Grove St
Suite 100
Haddon Heights, NJ 08035-1702
Phone (856) 796-9200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21580NJMDGeneral Practice Dentistry
25MA02158000NJMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lourdes Medical Associates PA PastSince Jul 9, 2007 Accepting new patients
Lourdes Medical Associates, PA Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341014400000",
    "number": "1255318390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 GROVE ST",
            "address_2": "SUITE 100",
            "city": "HADDON HEIGHTS",
            "state": "NJ",
            "postal_code": "080351702",
            "telephone_number": "856-796-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 HADDON AVE",
            "city": "COLLINGSWOOD",
            "state": "NJ",
            "postal_code": "081082047",
            "telephone_number": "856-854-4524",
            "fax_number": "856-854-8216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRA",
        "first_name": "JOHN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2012-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NJ",
            "license": "25MA02158000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collingswood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2012; 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.