NPIMap

Organization Active NPI

South Jersey Pediatric Gastroenterology, LLC

  • Pediatric Gastroenterology Physician
  • Mays Landing, NJ
National Provider Identifier
1497921845
Registry record updated May 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
25MA0719400 Issued in NJ
Legal business name
SOUTH JERSEY PEDIATRIC GASTROENTEROLOGY, LLC
Practice address
5429 Harding Hwy
Suite 302
Mays Landing, NJ 08330-2263
Phone
(609) 625-8688
Fax
(609) 625-4162
NPI assigned
May 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2008

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

Authorized official

Name
Dr. John Tung, MDNPI 1194832311
Title
Owner
Phone
(609) 625-8688

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0206X 25MA0719400 NJ Primary

Addresses

Primary practice location

5429 Harding Hwy
Suite 302
Mays Landing, NJ 08330-2263

Mailing address

5429 Harding Hwy
Suite 302
Mays Landing, NJ 08330-2263
Phone (609) 625-8688

Other identifiers 1

IdentifierTypeStateIssuer
8007101MedicaidNJ

Other names 1

  • SJPEDGI Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210032000000",
    "number": "1497921845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5429 HARDING HWY",
            "address_2": "SUITE 302",
            "city": "MAYS LANDING",
            "state": "NJ",
            "postal_code": "083302263",
            "telephone_number": "609-625-8688",
            "fax_number": "609-625-4162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5429 HARDING HWY",
            "address_2": "SUITE 302",
            "city": "MAYS LANDING",
            "state": "NJ",
            "postal_code": "083302263",
            "telephone_number": "609-625-8688",
            "fax_number": "609-625-4162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH JERSEY PEDIATRIC GASTROENTEROLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-06",
        "last_updated": "2008-05-06",
        "status": "A",
        "authorized_official_last_name": "TUNG",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-625-8688",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NJ",
            "license": "25MA0719400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8007101",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SJPEDGI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mays Landing, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; 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.