Organization Active NPI

Onsite Neonatal PA

  • Neonatal-Perinatal Medicine Physician
  • Voorhees, NJ
National Provider Identifier
1386652808
Registry record updated Sep 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
Legal business name
ONSITE NEONATAL PA
Practice address
1000 Haddonfield Berlin Rd
Suite 210
Voorhees, NJ 08043-3520
Phone
(856) 782-2212
Fax
(856) 782-2213
NPI assigned
Aug 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2013

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

Authorized official

Name
Mrs. Kelly Jack
Title
Billing Supervisor
Phone
(856) 782-2212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080N0001X NJ Primary

Addresses

Primary practice location

1000 Haddonfield Berlin Rd
Suite 210
Voorhees, NJ 08043-3520

Mailing address

1000 Haddonfield Berlin Rd
Suite 210
Voorhees, NJ 08043-3520
Phone (856) 782-2212

Other identifiers 1

IdentifierTypeStateIssuer
7009801MedicaidNJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378857600000",
    "number": "1386652808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HADDONFIELD BERLIN RD",
            "address_2": "SUITE 210",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080433520",
            "telephone_number": "856-782-2212",
            "fax_number": "856-782-2213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HADDONFIELD BERLIN RD",
            "address_2": "SUITE 210",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080433520",
            "telephone_number": "856-782-2212",
            "fax_number": "856-782-2213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONSITE NEONATAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2013-09-11",
        "status": "A",
        "authorized_official_last_name": "JACK",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "856-782-2212",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7009801",
            "state": "NJ"
        }
    ],
    "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 Sep 11, 2013; 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.