Individual provider Active NPI

Thomas G Stackhouse, MD

  • Surgery of the Hand (Surgery) Physician
  • Voorhees, NJ
National Provider Identifier
1578659082
Registry record updated Feb 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery of the Hand (Surgery) PhysicianTaxonomy code 2086S0105X
License
MA46176 Issued in NJ
Practice address
200 Bowman Dr
Suite E-100
Voorhees, NJ 08043-9623
Phone
(609) 267-9400
Fax
(609) 267-9457
NPI assigned
Oct 4, 2006
Last updated
Feb 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery of the Hand (Surgery) Physician 2086S0105X MA46176 NJ Primary
Specialist 174400000X MA46176 NJ

Addresses

Primary practice location

200 Bowman Dr
Suite E-100
Voorhees, NJ 08043-9623

Mailing address

4 Eves Dr # a
Suite 100
Marlton, NJ 08053-3195
Phone (609) 267-9400

Other identifiers 10

IdentifierTypeStateIssuer
6569F02206OtherNJ1ST OPTION
BNS012OtherNJOXFORD
0065218OtherNJGHI
3730395BOtherNJCIGNA
157012OtherNJGREAT WEST
0090628000OtherNJKEYSTONE
2K1291OtherNJHEALTHNET
4090523OtherNJAETNA
1243672OtherNJUNITED HEALTHCARE
0090628000OtherNJAMERIHEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA46176NJMDSurgery of the Hand (Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hand Surgery & Rehabilitation Center of New Jersey, PA Surgery of the Hand PastSince Feb 17, 2009 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424649600000",
    "number": "1578659082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 EVES DR # A",
            "address_2": "SUITE 100",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533195",
            "telephone_number": "609-267-9400",
            "fax_number": "609-267-9457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BOWMAN DR",
            "address_2": "SUITE E-100",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080439623",
            "telephone_number": "609-267-9400",
            "fax_number": "609-267-9457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACKHOUSE",
        "first_name": "THOMAS",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2015-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": "NJ",
            "license": "MA46176",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA46176",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1ST OPTION",
            "identifier": "6569F02206",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "BNS012",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0065218",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3730395B",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT WEST",
            "identifier": "157012",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE",
            "identifier": "0090628000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2K1291",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4090523",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1243672",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0090628000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; 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.