NPIMap

Organization Active NPI

CMC Department of Medicine Group PA

  • Neurology Physician
  • Sewell, NJ
National Provider Identifier
1437281771
Registry record updated Jul 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
CMC DEPARTMENT OF MEDICINE GROUP PA
Practice address
1 Plaza Dr
Chapel Heights & Hurfville-Cross Keys Roads
Sewell, NJ 08080-9207
Phone
(856) 270-4080
Fax
(856) 270-4085
NPI assigned
Mar 12, 2007
Last updated
Jul 1, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2008

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

Authorized official

Name
Robert McMullen
Title
Evp Managed Care
Phone
(856) 342-2921

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X Primary

Addresses

Primary practice location

1 Plaza Dr
Chapel Heights & Hurfville-Cross Keys Roads
Sewell, NJ 08080-9207

Mailing address

3 Cooper PLZ
Suite 502
Camden, NJ 08103-1438
Phone (856) 342-2921

Other identifiers 1

IdentifierTypeStateIssuer
2265447000OtherNJNEUROLOGY GRP#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050104000343 NJ Part B Supplier - Clinic/Group Practice 2163335878 Receives reassigned benefits from 452 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mount Laurel, NJ; Salem, NJ; Mullica Hill, NJ; Pennsville, NJ; Sewell, NJ; Swedesboro, NJ; Voorhees, NJ; West Deptford, NJ…

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1935 Route 70 E
Cherry Hill, NJ 08003
Phone (856) 246-3920

2339 Route 70 W
Fl 3
Cherry Hill, NJ 08002
Phone (856) 536-1500

221 Victoria St
Glassboro, NJ 08028
Phone (856) 536-1475

Practitioners & affiliated clinicians

Practitioners 51

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214870400000",
    "number": "1437281771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 COOPER PLZ",
            "address_2": "SUITE 502",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031438",
            "telephone_number": "856-342-2921",
            "fax_number": "856-968-8499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PLAZA DR",
            "address_2": "CHAPEL HEIGHTS & HURFVILLE-CROSS KEYS ROADS",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080809207",
            "telephone_number": "856-270-4080",
            "fax_number": "856-270-4085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMC DEPARTMENT OF MEDICINE GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2008-07-01",
        "status": "A",
        "authorized_official_last_name": "MCMULLEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "EVP MANAGED CARE",
        "authorized_official_telephone_number": "856-342-2921"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEUROLOGY GRP#",
            "identifier": "2265447000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sewell, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.