Active NPI
Linwood
- Skilled Nursing Facility
- Mount Laurel, NJ
National Provider Identifier
1376660787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 060104
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4462017 | Medicaid | NJ | |
| 4462009 | Medicaid | NJ |
National Provider Directory
National Provider DirectoryNPI 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
- Sungtae Lim, M.D.
- Melissa Lima-Alas
- Lincoln Healthcare of New Jersey, LLC (Lincoln Healthcare)
- Mark-Anthony A Lingaya
- Carly Linus, MS, RDN
- Stephan Lipinski, ATC
- Steven Litvack, M.D.
- Live Life Now Health Group of NJ PC (Monument Telehealth Group)
- Bernadette Maria Livewell, PA-C
- Barry J. Livstone, M.D.
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.