NPIMap

Organization Active NPI

CMC Department of Medicine Group PA

  • Pulmonary Disease Physician
  • Voorhees, NJ
National Provider Identifier
1265565667
Registry record updated Jul 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
CMC DEPARTMENT OF MEDICINE GROUP PA
Practice address
900 Centennial Blvd
Suite K
Voorhees, NJ 08043-4689
Phone
(856) 325-6789
Fax
(856) 325-6545
NPI assigned
Mar 14, 2007
Last updated
Jul 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2008

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

Authorized official

Name
Robert McMullen
Title
Evp Managed Care
Phone
(856) 342-2921

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X NU Primary

Addresses

Primary practice location

900 Centennial Blvd
Suite K
Voorhees, NJ 08043-4689

Mailing address

3 Cooper PLZ
Suite 502
Camden, NJ 08103-1438
Phone (856) 342-2921

Other identifiers 1

IdentifierTypeStateIssuer
0090398000OtherNJPULMONARY GRP#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050504000294 NJ Part B Supplier - Clinic/Group Practice 2163335878 Receives reassigned benefits from 38 practitioners
1 other NPI on this enrollment
Practice locations: Willingboro, NJ; Camden, NJ; Voorhees, NJ; Mullica Hill, NJ; Mount Laurel, NJ; Cherry Hill, NJ; Cape May Court House, NJ; Moorestown, NJ

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

3 Cooper Plz
Rm 318
Camden, NJ 08103
Phone (856) 342-2683

2339 Route 70 W
Fl 3
Cherry Hill, NJ 08002
Phone (856) 536-1500

3829 Church Rd
#B
Mount Laurel, NJ 08054
Phone (856) 234-1200

Practitioners & affiliated clinicians

Practitioners 43

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.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216166400000",
    "number": "1265565667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 COOPER PLZ",
            "address_2": "SUITE 502",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031438",
            "telephone_number": "856-342-2921",
            "fax_number": "856-968-8499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 CENTENNIAL BLVD",
            "address_2": "SUITE K",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434689",
            "telephone_number": "856-325-6789",
            "fax_number": "856-325-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMC DEPARTMENT OF MEDICINE GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2008-07-16",
        "status": "A",
        "authorized_official_last_name": "MCMULLEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "EVP MANAGED CARE",
        "authorized_official_telephone_number": "856-342-2921"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PULMONARY GRP#",
            "identifier": "0090398000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.