Vineland Medical Associates PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA02825000 Issued in NJ

Legal business name

VINELAND MEDICAL ASSOCIATES PA

Practice address

1100 E Chestnut Ave
Vineland, NJ 08360-5002

Phone

(856) 696-0108

Fax

(856) 691-1106

NPI assigned

Jun 24, 2005

Organization subpart

No

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

Authorized official

Name

Narasimhaloo Venugopal, M.D.

Title

President

Phone

(856) 696-0108

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558367441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E CHESTNUT AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605002",
            "telephone_number": "856-696-0108",
            "fax_number": "856-691-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E CHESTNUT AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605002",
            "telephone_number": "856-696-0108",
            "fax_number": "856-691-1106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINELAND MEDICAL ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VENUGOPAL",
        "authorized_official_first_name": "NARASIMHALOO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-696-0108",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA02825000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TIN",
            "identifier": "2231287739",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2875501",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Vineland, NJ
• Providers in Vineland, 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 Aug 22, 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.