Active NPI
Colin Anthony Pumphrey
- Physician Assistant
- Berlin, NJ
National Provider Identifier
1447987003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 25MP00749200
- Practice address
- 175 Cross Keys Rd
Berlin, NJ 08009-9263 - Phone
- (856) 767-0077
- NPI assigned
- Aug 3, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 25MP00749200 | NJ | Primary |
Addresses
Primary practice location
175 Cross Keys Rd
Berlin, NJ 08009-9263
Mailing address
401 Route 73 N Ste 320
Marlton, NJ 08053-3426
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MP00749200 | NJ | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advocare, LLC | Current | Accepting new patients | |
| Advocare , LLC | Current | Accepting new patients | |
| Advocare, LLC | Past | Accepting new patients |
Locations
339 N Route 73
Ste 1
Berlin, NJ 08009
Phone (856) 767-8228
132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211
401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatrics Physician
- Marlton, NJ
- NPI 1770538696
-
dba Advocare Berlin Medical Associates (DME)
- Internal Medicine Physician
- Manahawkin, NJ
- NPI 1912762162
-
dba Advocare Merchantville Pediatrics
- Pediatrics Physician
- Cherry Hill, NJ
- NPI 1780696732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667952000000",
"number": "1447987003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 ROUTE 73 N STE 320",
"city": "MARLTON",
"state": "NJ",
"postal_code": "080533426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 CROSS KEYS RD",
"city": "BERLIN",
"state": "NJ",
"postal_code": "080099263",
"telephone_number": "856-767-0077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUMPHREY",
"first_name": "COLIN",
"middle_name": "ANTHONY",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-08-03",
"last_updated": "2022-11-09",
"certification_date": "2022-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NJ",
"license": "25MP00749200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Berlin, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.