Organization Active NPI

Linwood

  • Skilled Nursing Facility
  • Mount Laurel, NJ
National Provider Identifier
1376660787
Registry record updated Aug 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
060104 Issued in NJ
Legal business name
LINWOOD
Practice address
525 Fellowship Rd
Suite 360
Mount Laurel, NJ 08054-3415
Phone
(856) 813-2000
Fax
(856) 813-2020
NPI assigned
Mar 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2007

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

Authorized official

Name
Mrs. Tramell C Clark
Title
Regional Resident Accounting MGR
Phone
(856) 813-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 060104 NJ Primary

Addresses

Primary practice location

525 Fellowship Rd
Suite 360
Mount Laurel, NJ 08054-3415

Mailing address

New Road & Central Ave
Linwood, NJ 08221
Phone (856) 813-2000

Other identifiers 2

IdentifierTypeStateIssuer
4462017MedicaidNJ
4462009MedicaidNJ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187049600000",
    "number": "1376660787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NEW ROAD & CENTRAL AVE",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "08221",
            "telephone_number": "856-813-2000",
            "fax_number": "856-813-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 FELLOWSHIP RD",
            "address_2": "SUITE 360",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080543415",
            "telephone_number": "856-813-2000",
            "fax_number": "856-813-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINWOOD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2007-08-14",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "TRAMELL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "REGIONAL RESIDENT ACCOUNTING MGR",
        "authorized_official_telephone_number": "856-813-2000",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NJ",
            "license": "060104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4462017",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4462009",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2007; 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.