NPIMap

Organization Active NPI

Penn Valley Anesthesia Associates, LLC

  • Anesthesiology Physician
  • Voorhees, NJ
National Provider Identifier
1346227543
Registry record updated Nov 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
PENN VALLEY ANESTHESIA ASSOCIATES, LLC
Practice address
1000 White Horse Rd Ste 612
Voorhees, NJ 08043-4412
Phone
(856) 845-1355
Fax
(856) 358-8053
NPI assigned
Dec 28, 2005
Last updated
Nov 19, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2020

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

Authorized official

Name
Robert E Hawk, CRNA
Title
Ceo/Member
Phone
(856) 451-3552

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X Primary
Certified Registered Nurse Anesthetist 367500000X

Addresses

Primary practice location

1000 White Horse Rd Ste 612
Voorhees, NJ 08043-4412

Mailing address

1000 White Horse Rd Ste 612
Voorhees, NJ 08043-4412
Phone (856) 451-3552

Other identifiers 1

IdentifierTypeStateIssuer
1014588880001MedicaidPA

National Provider Directory

National Provider Directory

Locations

133 Gaither Dr
Ste K
Mount Laurel, NJ 08054
Phone (856) 451-3552

Practitioners & affiliated clinicians

Practitioners 31

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 31

NPI Registry JSON

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605744000000",
    "number": "1346227543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 WHITE HORSE RD STE 612",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434412",
            "telephone_number": "856-451-3552",
            "fax_number": "856-358-8053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WHITE HORSE RD STE 612",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434412",
            "telephone_number": "856-845-1355",
            "fax_number": "856-358-8053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENN VALLEY ANESTHESIA ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-28",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A",
        "authorized_official_last_name": "HAWK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO/MEMBER",
        "authorized_official_telephone_number": "856-451-3552",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1014588880001",
            "state": "PA"
        }
    ],
    "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 Nov 19, 2020; 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.