Organization Active NPI

Cardiovascular Associates of the Delaware Valley,P a

  • Cardiovascular Disease Physician
  • Haddon Heights, NJ
National Provider Identifier
1366495632
Registry record updated Dec 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CARDIOVASCULAR ASSOCIATES OF THE DELAWARE VALLEY,P A
Practice address
210 W Atlantic Ave
Haddon Heights, NJ 08035-1715
Phone
(856) 547-0539
Fax
(856) 547-3178
NPI assigned
May 18, 2006
Last updated
Dec 10, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2007

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

Authorized official

Name
Kim Dawson
Title
Director of Business Office
Phone
(856) 547-0539

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X Primary

Addresses

Primary practice location

210 W Atlantic Ave
Haddon Heights, NJ 08035-1715

Mailing address

120 White Horse Pike
Suite 112
Haddon Heights, NJ 08035-1927
Phone (856) 547-0539

Other identifiers 1

IdentifierTypeStateIssuer
6300006MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040602001172 PA Part B Supplier - Clinic/Group Practice 9032001284 Receives reassigned benefits from 12 practitioners
Practice locations: Philadelphia, PA
O20040804000725 NJ Part B Supplier - Clinic/Group Practice 9032001284 Receives reassigned benefits from 104 practitioners
Practice locations: Marlton, NJ; Neptune, NJ; Sewell, NJ; Stratford, NJ; Tinton Falls, NJ; Toms River, NJ; Turnersville, NJ; Vineland, NJ…

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D1107213Cardiovascular Assoc of the Delaware Valley, PA210 West Atlantic Avenue, Haddon Heights, NJ 08035Certificate of waiverOct 29, 2027

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

35 Beaverson Blvd
Ste 8D
Brick, NJ 08723

120 White Horse Pike
Ste 112
Haddon Hgts, NJ 08035
Phone 85654705392215

777 S White Horse Pike
Ste B3
Hammonton, NJ 08037
Phone (856) 546-3003

1 State Route 35
Ste 2
Keyport, NJ 07735
Phone (732) 335-3937

999 Route 73 N
Ste 205
Marlton, NJ 08053
Phone (856) 795-2227

9 Mule Rd
Ste E1
Toms River, NJ 08755
Phone (732) 281-1101

1038 E Chestnut Ave
Ste 101
Vineland, NJ 08360

1051 W Sherman Ave
Bldg 3
Vineland, NJ 08360

1051 W Sherman Ave
Ste 3
Vineland, NJ 08360
Phone (856) 691-8070

190 N Evergreen Ave
Ste 102B1
Woodbury, NJ 08096

111 S 11th St
#2210
Philadelphia, PA 19107
Phone (215) 955-7106

111 S 11th St
Ste 5340
Philadelphia, PA 19107

Practitioners & affiliated clinicians

Practitioners 191

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 191

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197244800000",
    "number": "1366495632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 WHITE HORSE PIKE",
            "address_2": "SUITE 112",
            "city": "HADDON HEIGHTS",
            "state": "NJ",
            "postal_code": "080351927",
            "telephone_number": "856-547-0539",
            "fax_number": "856-547-3178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W ATLANTIC AVE",
            "city": "HADDON HEIGHTS",
            "state": "NJ",
            "postal_code": "080351715",
            "telephone_number": "856-547-0539",
            "fax_number": "856-547-3178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR ASSOCIATES OF THE DELAWARE VALLEY,P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2007-12-10",
        "status": "A",
        "authorized_official_last_name": "DAWSON",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS OFFICE",
        "authorized_official_telephone_number": "856-547-0539"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6300006",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Haddon Heights, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.