Sr Campus Primary Care Physicians PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SR CAMPUS PRIMARY CARE PHYSICIANS PC

Practice address

3000 Essex Rd
Tinton Falls, NJ 07753-2631

Phone

(732) 643-2070

Fax

(732) 643-2015

NPI assigned

May 12, 2008

Last updated

Oct 6, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matthew J Narrett, MD

Title

Executive VP Chief Medical Officer

Phone

(410) 402-2258

Specialties & licenses 5

Addresses

Other identifiers 1

Tax ID family

Senior Campus Primary Care Physicians PC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Senior Campus Primary Care Physicians PC

  • Durable Medical Equipment & Medical Supplies
  • Pompton Plains, NJ
  • NPI 1649426081
  NPD tax ID
• Senior Campus Primary Care Physicians PC

  • Internal Medicine Physician
  • Pompton Plains, NJ
  • NPI 1760659379
  NPD tax ID
• Senior Campus Primary Care Physicians, PC

  • Durable Medical Equipment & Medical Supplies
  • Tinton Falls, NJ
  • NPI 1245381805
  NPD tax ID

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223251200000",
    "number": "1538336359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 MAIDEN CHOICE LN",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212285968",
            "telephone_number": "410-402-2258",
            "fax_number": "410-402-2264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 ESSEX RD",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077532631",
            "telephone_number": "732-643-2070",
            "fax_number": "732-643-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SR CAMPUS PRIMARY CARE PHYSICIANS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-12",
        "last_updated": "2008-10-06",
        "status": "A",
        "authorized_official_last_name": "NARRETT",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE VP CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "410-402-2258",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": null,
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0021873",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alicia E Sparks
• Speech Therapy Services
• Spine & Sports Medicine of Tinton Falls LLC
• Robert Springer
• Kaitlyn Alaze Squires-Black, BCBA
• Sharon W Stark, PHD, RN, APRN, BC
• Starlight ABA NJ LLC
• Steady Anchor Counseling Center LLC
• Stephen a. Chagares, MD, PC
• Vicki Stollsteimer, MSW

• Internal Medicine Physician in Tinton Falls, NJ
• Providers in Tinton Falls, NJ by specialty
• Internal Medicine Physician in New Jersey

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