NPIMap

Organization Active NPI

Integrated Childrens Health

  • Pediatrics Physician
  • Marlton, NJ
National Provider Identifier
1407974512
Registry record updated Mar 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA07926600 Issued in NJ
Legal business name
INTEGRATED CHILDRENS HEALTH
Practice address
528 Lippincott Dr
Marlton, NJ 08053-4805
Phone
(856) 983-3899
Fax
(856) 983-3997
NPI assigned
Mar 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2014

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

Authorized official

Name
Dr. Ramesh Ragothaman, M.D.
Title
Pediatrician
Phone
(856) 983-3899

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 25MA07926600 NJ Primary

Addresses

Primary practice location

528 Lippincott Dr
Marlton, NJ 08053-4805

Mailing address

41 Las Brisas Blvd
Voorhees, NJ 08043-3421
Phone (856) 772-0483

Other identifiers 1

IdentifierTypeStateIssuer
0084972MedicaidNJ

Other names 1

  • Mount Laurel Pediatrics LLC Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394150400000",
    "number": "1407974512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 LAS BRISAS BLVD",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080433421",
            "telephone_number": "856-772-0483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 LIPPINCOTT DR",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534805",
            "telephone_number": "856-983-3899",
            "fax_number": "856-983-3997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED CHILDRENS HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2014-03-07",
        "status": "A",
        "authorized_official_last_name": "RAGOTHAMAN",
        "authorized_official_first_name": "RAMESH",
        "authorized_official_title_or_position": "PEDIATRICIAN",
        "authorized_official_telephone_number": "856-983-3899",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA07926600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0084972",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mount Laurel Pediatrics LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marlton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2014; 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.