Underwood-Memorial Hospital

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

UNDERWOOD-MEMORIAL HOSPITAL

Practice address

1 W Broad St
Paulsboro, NJ 08066-1527

Phone

(856) 423-0033

Fax

(856) 423-4444

NPI assigned

Jan 8, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Edward Shields

Title

Director Oof Practice Management

Phone

(856) 845-0100

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1568510568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 DELSEA DR N",
            "city": "GLASSBORO",
            "state": "NJ",
            "postal_code": "080281444",
            "telephone_number": "856-423-0033",
            "fax_number": "856-423-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W BROAD ST",
            "city": "PAULSBORO",
            "state": "NJ",
            "postal_code": "080661527",
            "telephone_number": "856-423-0033",
            "fax_number": "856-423-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNDERWOOD-MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "SHIELDS",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "DIRECTOR OOF PRACTICE MANAGEMENT",
        "authorized_official_telephone_number": "856-845-0100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7183411",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.