NPIMap

Organization Active NPI

Northlands Orthopaedic & Sports Medicine PA

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Wayne, NJ
National Provider Identifier
1588740195
Registry record updated Apr 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
25MA05626700 Issued in NJ
Legal business name
NORTHLANDS ORTHOPAEDIC & SPORTS MEDICINE PA
Practice address
504 Valley Rd
Suite 200
Wayne, NJ 07470-3534
Phone
(973) 694-2690
Fax
(973) 694-2692
NPI assigned
Oct 27, 2006
Last updated
Apr 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2008

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

Authorized official

Name
Vincent K McInerney, MDNPI 1669496865
Title
President/Owner
Phone
(973) 694-2690

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 25MA05626700 NJ Primary

Addresses

Primary practice location

504 Valley Rd
Suite 200
Wayne, NJ 07470-3534

Mailing address

504 Valley Rd
Suite 200
Wayne, NJ 07470-3534
Phone (973) 694-2690

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207267200000",
    "number": "1588740195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 VALLEY RD",
            "address_2": "SUITE 200",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074703534",
            "telephone_number": "973-694-2690",
            "fax_number": "973-694-2692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 VALLEY RD",
            "address_2": "SUITE 200",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074703534",
            "telephone_number": "973-694-2690",
            "fax_number": "973-694-2692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLANDS ORTHOPAEDIC & SPORTS MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2008-04-04",
        "status": "A",
        "authorized_official_last_name": "MCINERNEY",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "973-694-2690",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NJ",
            "license": "25MA05626700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.