Active NPI
Virtua Medical Group, PA
Doing business as Rowan Medicine Psychiatry - Mount Laurel, an affiliate of VMG
- Psychiatry Physician
- Mount Laurel, NJ
National Provider Identifier
1417219619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Legal business name
- VIRTUA MEDICAL GROUP, PA
- Doing business as
- Rowan Medicine Psychiatry - Mount Laurel, an affiliate of VMG
- Practice address
- 100 Century Pkwy Ste 350
Mount Laurel, NJ 08054-1149 - Phone
- (856) 482-9000
- Fax
- (856) 482-1159
- NPI assigned
- Jun 13, 2012
- 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
- John Mark Matsinger, DO
- Title
- Evp; Chief Operating Officer
- Phone
- (856) 355-0340
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | |||
| Family Medicine Physician | 207Q00000X | |||
| Physical Medicine & Rehabilitation Physician | 208100000X | |||
| Psychiatry Physician | 2084P0800X | Primary |
Addresses
Primary practice location
100 Century Pkwy Ste 350
Mount Laurel, NJ 08054-1149
Mailing address
301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 355-0340
Other names 1
- Rowan Medicine Psychiatry - Mount Laurel, an affiliate of VMG
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 31D0724656 | Rowan Family Medicine - Mt Laurel | Provider-performed microscopy | Feb 23, 2027 |
| 31D2300336 | Rowan Psychiatry | Certificate of waiver | Mar 6, 2028 |
National Provider Directory
National Provider DirectoryLocations
100 Kings Way E
Ste D3A
Sewell, NJ 08080
Phone (856) 341-8495
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339545600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1717977600000",
"number": "1417219619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 LIPPINCOTT DR STE 410",
"city": "MARLTON",
"state": "NJ",
"postal_code": "080534197",
"telephone_number": "856-355-0340",
"fax_number": "856-355-0330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 CENTURY PKWY STE 350",
"city": "MOUNT LAUREL",
"state": "NJ",
"postal_code": "080541149",
"telephone_number": "856-482-9000",
"fax_number": "856-482-1159"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VIRTUA MEDICAL GROUP, PA",
"organizational_subpart": "NO",
"enumeration_date": "2012-06-13",
"last_updated": "2024-06-10",
"certification_date": "2024-06-10",
"status": "A",
"authorized_official_last_name": "MATSINGER",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "MARK",
"authorized_official_title_or_position": "EVP; CHIEF OPERATING OFFICER",
"authorized_official_telephone_number": "856-355-0340",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Medicine & Rehabilitation",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Rowan Medicine Psychiatry - Mount Laurel, an affiliate of VMG",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Mount Laurel, NJ
- Paul L Vernon, M.D.
- Verus Healthcare, LLC
- Vip Rheumatology
- Virtua - Memorial Hospital of Burlington County, Inc. (Virtua HomeCare Community Nursing Services)
- Virtua Home Care -Commumity Nursing Services Inc
- Visionary Eye Care Associates LLC
- Vitas Health Services of New Jersey, P.a. (Palliative Medical Associates of New Jersey)
- Vitas Healthcare Corporation Atlantic
- Jeanna Vizzard, PT
- Vri, Inc (Virtua Home Caregivers)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.