NPIMap

Organization Active NPI

St. Luke's Warren Physician Group, PC

  • Obstetrics & Gynecology Physician
  • Phillipsburg, NJ
National Provider Identifier
1578041174
Registry record updated Oct 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
ST. LUKE'S WARREN PHYSICIAN GROUP, PC
Practice address
39 Roseberry St Ste 2
Phillipsburg, NJ 08865-1627
Phone
(908) 847-1037
Fax
(908) 847-1038
NPI assigned
Aug 6, 2018
Last updated
Oct 2, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2018

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

Authorized official

Name
Jamie L Thomas
Title
Owner
Phone
(908) 847-6702

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

39 Roseberry St Ste 2
Phillipsburg, NJ 08865-1627

Mailing address

185 Roseberry St
Farley BLDG., 2ND Floor
Phillipsburg, NJ 08865
Phone (908) 847-2621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040323000967 NJ Part B Supplier - Clinic/Group Practice 9739093675 Receives reassigned benefits from 216 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Phillipsburg, NJ; Washington, NJ; Hampton, NJ

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538438400000",
    "number": "1578041174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 ROSEBERRY ST",
            "address_2": "FARLEY BLDG., 2ND FLOOR",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "08865",
            "telephone_number": "908-847-2621",
            "fax_number": "908-847-3045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 ROSEBERRY ST STE 2",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088651627",
            "telephone_number": "908-847-1037",
            "fax_number": "908-847-1038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S WARREN PHYSICIAN GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-06",
        "last_updated": "2018-10-02",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-847-6702"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phillipsburg, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.