NPIMap

Organization Active NPI

Hainesport Family Medicine LLC

  • Family Medicine Physician
  • Hainesport, NJ
National Provider Identifier
1497786719
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HAINESPORT FAMILY MEDICINE LLC
Practice address
310 Creek Crossing Blvd
Hainesport, NJ 08036-2767
Phone
(609) 702-0014
Fax
(609) 702-7225
NPI assigned
Jul 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Authorized official

Name
Michael Meltzer, DO
Title
President
Phone
(609) 702-0014

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

310 Creek Crossing Blvd
Hainesport, NJ 08036-2767

Mailing address

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

National Provider Directory

National Provider Directory

Locations

310 Creek Crossing Blvd
Hainesport, NJ 08036
Phone (609) 702-0014

1299 Route 38
Ste 8
Hainesport, NJ 08036
Phone (609) 288-6884

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599609600000",
    "number": "1497786719",
    "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": "310 CREEK CROSSING BLVD",
            "city": "HAINESPORT",
            "state": "NJ",
            "postal_code": "080362767",
            "telephone_number": "609-702-0014",
            "fax_number": "609-702-7225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAINESPORT FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A",
        "authorized_official_last_name": "MELTZER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "609-702-0014",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hainesport, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; 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.