Vivant Medical Care PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

VIVANT MEDICAL CARE PC

Practice address

1025 Linden Ave
Ridgefield, NJ 07657-1006

Phone

(201) 282-7556

NPI assigned

Nov 17, 2021

Organization subpart

No

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

Authorized official

Name

Samir Khalil, MD

Title

President

Phone

(201) 282-7556

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1637107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637107200000",
    "number": "1376209072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 LINDEN AVE",
            "city": "RIDGEFIELD",
            "state": "NJ",
            "postal_code": "076571006",
            "telephone_number": "201-282-7556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 LINDEN AVE",
            "city": "RIDGEFIELD",
            "state": "NJ",
            "postal_code": "076571006",
            "telephone_number": "201-282-7556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVANT MEDICAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-17",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A",
        "authorized_official_last_name": "KHALIL",
        "authorized_official_first_name": "SAMIR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-282-7556",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.