Organization Active NPI

Colon and Rectal Surgical Center of South Jersey

  • Specialist
  • Lumberton, NJ
National Provider Identifier
1295879146
Registry record updated Feb 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
COLON AND RECTAL SURGICAL CENTER OF SOUTH JERSEY
Practice address
217 Madison Ave
Lumberton, NJ 08048-2901
Phone
(609) 261-5550
Fax
(609) 261-3009
NPI assigned
Feb 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2008

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

Authorized official

Name
Tara L Kowalewski
Title
Billing MGR
Phone
(856) 753-0913

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

217 Madison Ave
Lumberton, NJ 08048-2901

Mailing address

501 Office Center Dr
Suite 188
Fort Washington, PA 19034-3220
Phone (609) 261-5550

Other identifiers 1

IdentifierTypeStateIssuer
7909306MedicaidNJ

National Provider Directory

National Provider Directory

Locations

501 Office Center Dr
Ste 188
Ft Washington, PA 19034

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202256000000",
    "number": "1295879146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 OFFICE CENTER DR",
            "address_2": "SUITE 188",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190343220",
            "telephone_number": "609-261-5550",
            "fax_number": "609-261-3009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 MADISON AVE",
            "city": "LUMBERTON",
            "state": "NJ",
            "postal_code": "080482901",
            "telephone_number": "609-261-5550",
            "fax_number": "609-261-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLON AND RECTAL SURGICAL CENTER OF SOUTH JERSEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2008-02-06",
        "status": "A",
        "authorized_official_last_name": "KOWALEWSKI",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BILLING MGR",
        "authorized_official_telephone_number": "856-753-0913"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7909306",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lumberton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2008; 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.