Medexpress Urgent Care - New Jersey, Inc

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

MEDEXPRESS URGENT CARE - NEW JERSEY, INC

Doing business as

MedExpress Urgent Care - Mount Ephraim

Practice address

2 S Black Horse Pike
Mount Ephraim, NJ 08059-1321

Phone

(856) 931-3107

Fax

(856) 931-3230

NPI assigned

Oct 21, 2013

Last updated

Sep 8, 2016By 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

Mr. Timothy G. Bugin

Title

VP of Payor Contracting

Phone

(304) 225-2500

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• MedExpress Urgent Care - Mount Ephraim Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1382313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473292800000",
    "number": "1548698012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 CONSOL ENERGY DR",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153176506",
            "telephone_number": "304-225-2500",
            "fax_number": "724-743-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 S BLACK HORSE PIKE",
            "city": "MOUNT EPHRAIM",
            "state": "NJ",
            "postal_code": "080591321",
            "telephone_number": "856-931-3107",
            "fax_number": "856-931-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDEXPRESS URGENT CARE - NEW JERSEY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-21",
        "last_updated": "2016-09-08",
        "status": "A",
        "authorized_official_last_name": "BUGIN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "VP OF PAYOR CONTRACTING",
        "authorized_official_telephone_number": "304-225-2500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0347116",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedExpress Urgent Care - Mount Ephraim",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicole Lynne Kizitaff, RDN
• Renato Richard Latini, D.D.S.
• Shikeena Lynard, LAC
• Paige Mason, LCSW
• Ashley Matousek
• Alicia Latoya Meyers
• Mount Ephraim Police Reserves Inc. (M.E.P.R.I.)
• Mount Ephraim School District
• Mt. Ephraim Public School
• Mt. Ephraim School District

• Urgent Care Clinic/Center in Mount Ephraim, NJ
• Providers in Mount Ephraim, NJ by specialty
• Urgent Care Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.