Active NPI
Thomas G Stackhouse, MD
- Surgery of the Hand (Surgery) Physician
- Voorhees, NJ
National Provider Identifier
1578659082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery of the Hand (Surgery) Physician
- License
- MA46176
- 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, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6569F02206 | Other | NJ | 1ST OPTION |
| BNS012 | Other | NJ | OXFORD |
| 0065218 | Other | NJ | GHI |
| 3730395B | Other | NJ | CIGNA |
| 157012 | Other | NJ | GREAT WEST |
| 0090628000 | Other | NJ | KEYSTONE |
| 2K1291 | Other | NJ | HEALTHNET |
| 4090523 | Other | NJ | AETNA |
| 1243672 | Other | NJ | UNITED HEALTHCARE |
| 0090628000 | Other | NJ | AMERIHEALTH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA46176 | NJ | MD | Surgery of the Hand (Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hand Surgery & Rehabilitation Center of New Jersey, PA | Surgery of the Hand | Past | 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.
-
- Surgery of the Hand (Surgery) Physician
- Marlton, NJ
- NPI 1972673713
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.