NPIMap

Organization Active NPI

Lourdes Medical Associates, PA

  • Family Medicine Physician
  • Cherry Hill, NJ
National Provider Identifier
1316117294
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB07810300 Issued in NJ
Legal business name
LOURDES MEDICAL ASSOCIATES, PA
Practice address
101 Barclay Pavilion W
Cherry Hill, NJ 08034-2139
Phone
(856) 429-4179
Fax
(856) 429-3794
NPI assigned
Mar 6, 2008
Organization subpart
Yes
Parent organization
LOURDES MEDICAL ASSOCIATES, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Mr. Steven Fox, MD
Title
President
Phone
(856) 796-9200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 25MB07810300 NJ Primary

Addresses

Primary practice location

101 Barclay Pavilion W
Cherry Hill, NJ 08034-2139

Mailing address

500 Grove St Ste 100
Haddon Heights, NJ 08035-1761
Phone (856) 796-9200

Other practice location 1

951 Haddonfield Berlin Rd
Cherry Hill, NJ 08034-3512
Phone (856) 429-4179

Other identifiers 1

IdentifierTypeStateIssuer
6535704MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Laurdes Medical Assoc P65 organizations share this tax ID, including this one
Part of
Laurdes Medical Assoc P

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

101 Barclay Pavilion W
Cherry Hill, NJ 08034
Phone (856) 429-4179

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1316117294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 GROVE ST STE 100",
            "city": "HADDON HEIGHTS",
            "state": "NJ",
            "postal_code": "080351761",
            "telephone_number": "856-796-9200",
            "fax_number": "856-796-9397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BARCLAY PAVILION W",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342139",
            "telephone_number": "856-429-4179",
            "fax_number": "856-429-3794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "951 Haddonfield Berlin Rd",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080343512",
            "country_code": "US",
            "telephone_number": "856-429-4179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LOURDES MEDICAL ASSOCIATES, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOURDES MEDICAL ASSOCIATES, PA",
        "enumeration_date": "2008-03-06",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-796-9200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB07810300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6535704",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.