NPIMap

Individual provider Active NPI

Ronald P Willoughby, D.O.

  • Family Medicine Physician
  • Browns Mills, NJ
National Provider Identifier
1477582823
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB04822200 Issued in NJ
Practice address
130 Lakehurst Rd
Browns Mills, NJ 08015-6057
Phone
(609) 893-3133
Fax
(609) 893-7972
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MB04822200 NJ Primary

Addresses

Primary practice location

130 Lakehurst Rd
Browns Mills, NJ 08015-6057

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 355-0340

Other identifiers 1

IdentifierTypeStateIssuer
2357305MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rwilloughby14200@directvirtua.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100205000096 NJ Practitioner - Family Practice 7113060666 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

130 Lakehurst Rd
Browns Mills, NJ 08015-6057
Phone (855) 548-7634

2225 E Evesham Rd
Voorhees, NJ 08043-1557

3242 Route 206
Bordentown, NJ 08505-4517

Hospital & facility affiliations

  • Virtua Home Care at West Jersey Home health agency, Marlton, NJ, CCN 317071
  • Moorestown Visiting Nurse Association Home health agency, Moorestown, NJ, CCN 317048
  • Bayada Home Health Care, Inc Home health agency, Pennsauken, NJ, CCN 317065
  • Samaritan Healthcare and Hospice Hospice, Mount Laurel, NJ, CCN 311504
  • Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057
  • Deborah Heart and Lung Center Hospital, Browns Mills, NJ, CCN 310031
  • Virtua Willingboro Hospital Hospital, Willingboro, NJ, CCN 310061

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua - Memorial Hospital Burlington County, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rwilloughby14200@directvirtua.org

Organizations & group practices 2

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1477582823",
    "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": "130 LAKEHURST RD",
            "city": "BROWNS MILLS",
            "state": "NJ",
            "postal_code": "080156057",
            "telephone_number": "609-893-3133",
            "fax_number": "609-893-7972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLOUGHBY",
        "first_name": "RONALD",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB04822200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2357305",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rwilloughby14200@directvirtua.org",
            "affiliation": "N",
            "address_1": "130 Lakehurst Rd",
            "city": "Browns Mills",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080156057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Browns Mills, NJ

Sources for this page

Verify at the official NPI Registry.