NPIMap

Organization Active NPI

Lourdes Medical Associates, PA

  • Internal Medicine Physician
  • Haddon Township, NJ
National Provider Identifier
1548430317
Registry record updated Dec 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA06771400 Issued in NJ
Legal business name
LOURDES MEDICAL ASSOCIATES, PA
Practice address
216 Haddon Ave
Suite 100
Haddon Township, NJ 08108-2809
Phone
(856) 854-6600
Fax
(856) 854-6700
NPI assigned
Mar 7, 2008
Organization subpart
Yes
Parent organization
LOURDES MEDICAL ASSOCIATES, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 4, 2017

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

Authorized official

Name
Dr. Steven Fox
Title
Cfo
Phone
(856) 796-9200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 25MA06771400 NJ Primary

Addresses

Primary practice location

216 Haddon Ave
Suite 100
Haddon Township, NJ 08108-2809

Mailing address

500 Grove St
Suite 100
Haddon Heights, NJ 08035-1702
Phone (856) 796-9200

Other identifiers 1

IdentifierTypeStateIssuer
6535704MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Laurdes Medical Assoc P65 organizations share this tax ID, including this one
Part of
Laurdes Medical Assoc P

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512345600000",
    "number": "1548430317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 GROVE ST",
            "address_2": "SUITE 100",
            "city": "HADDON HEIGHTS",
            "state": "NJ",
            "postal_code": "080351702",
            "telephone_number": "856-796-9200",
            "fax_number": "856-796-9397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 HADDON AVE",
            "address_2": "SUITE 100",
            "city": "HADDON TOWNSHIP",
            "state": "NJ",
            "postal_code": "081082809",
            "telephone_number": "856-854-6600",
            "fax_number": "856-854-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOURDES MEDICAL ASSOCIATES, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOURDES MEDICAL ASSOCIATES, PA",
        "enumeration_date": "2008-03-07",
        "last_updated": "2017-12-04",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "856-796-9200",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA06771400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6535704",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Haddon Township, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2017; 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.