Ua Medical Services LLC

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

25MA08493700 Issued in NJ

Legal business name

UA MEDICAL SERVICES LLC

Practice address

300 Perrine Rd
Suite 333
Old Bridge, NJ 08857

Phone

(732) 289-9335

Fax

(732) 289-9336

NPI assigned

Jul 6, 2015

Reactivated

Jan 14, 2022

Organization subpart

No

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

Authorized official

Name

Georgia Chandler

Title

Director Off Billing and Revenue

Phone

(732) 719-7168

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1436140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642118400000",
    "number": "1467835637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PERRINE RD STE 330",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088573629",
            "telephone_number": "732-719-7168",
            "fax_number": "908-300-5152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PERRINE RD",
            "address_2": "SUITE 333",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "08857",
            "telephone_number": "732-289-9335",
            "fax_number": "732-289-9336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UA MEDICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-06",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "deactivation_date": "2021-04-08",
        "reactivation_date": "2022-01-14",
        "status": "A",
        "authorized_official_last_name": "CHANDLER",
        "authorized_official_first_name": "GEORGIA",
        "authorized_official_title_or_position": "DIRECTOR OFF BILLING AND REVENUE",
        "authorized_official_telephone_number": "732-719-7168"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NJ",
            "license": "25MA08493700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; 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.