NPIMap

Organization Active NPI

South Jersey Hospital, Inc.

Doing business as SJH Sports Rehab Care - Tomlin Station

  • Physical Therapy Clinic/Center
  • Mullica Hill, NJ
National Provider Identifier
1609158732
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
NOT APPLICABLE Issued in NU
Legal business name
SOUTH JERSEY HOSPITAL, INC.
Doing business as
SJH Sports Rehab Care - Tomlin Station
Practice address
201 Tomlin Station Road
Suite D
Mullica Hill, NJ 08062
Phone
(856) 423-8633
NPI assigned
Sep 14, 2011
Last updated
Sep 14, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTH JERSEY HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 14, 2011

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

Authorized official

Name
Mr. John Albert Diangelo
Title
Sr. Vice President Finance & Cfo
Phone
(856) 641-8610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NOT APPLICABLE NU Primary

Addresses

Primary practice location

201 Tomlin Station Road
Suite D
Mullica Hill, NJ 08062

Mailing address

333 Irving Ave
Bridgeton, NJ 08302-2123
Phone (856) 575-4777

Other names 1

  • SJH Sports Rehab Care - Tomlin Station Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080710000325 NJ Part A Provider - Hospital 0345232997 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Woolwich TWP, NJ; Woodbury, NJ; Deptford, NJ; Mullica Hill, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609158732. Details of each certification follow.

Hospital certification: CCN 310069

Legal name
INSPIRA MEDICAL CENTERS INC
Doing business as
INSPIRA MEDICAL CENTER MULLICA HILL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Dec 13, 2024
Beds
91
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jul 1, 1985 in NJ
Enrollment address
700 Mullica Hill Rd
Mullica Hill, NJ 80624413
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Inspira Medical Center Mullica HillCCN 310069 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Part of
Bridgeton Hospital

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Warren E. Moore Individual Corporate OfficerExecutive VP and Coo Jul 12, 2021 100%
W-2 Managing EmployeeExecutive VP and Coo Jul 12, 2021 100%
Operational/Managerial ControlExecutive VP and Coo Jul 12, 2021 100%
Owen J Giryluk Individual W-2 Managing EmployeeDirector of Strategic Finance Jan 1, 2015 100%
James T O'Connell Individual W-2 Managing EmployeeDirector of Revenue Cycle May 23, 2008
Lydia Stockman Individual Corporate OfficerSr. VP and Chief Admin. Officer Jan 16, 2023 100%
W-2 Managing EmployeeSr. VP and Chief Admin. Officer Jan 16, 2023 100%
Operational/Managerial ControlSr. VP and Chief Admin. Officer Jan 16, 2023 100%
William Pelino Individual Corporate OfficerSenior VP and Cfo Feb 6, 2023 100%
W-2 Managing EmployeeSenior VP and Cfo Feb 6, 2023 100%
Operational/Managerial ControlSenior VP and Cfo Feb 6, 2023 100%
Inspira Health Network Inc Organization, Mullica Hill, NJ Corporation, Non-profit 5% Or Greater Direct Ownership Interest May 23, 2008 100%
Jeffrey S. Smaniotto Individual W-2 Managing EmployeeDirector Reimbursement Jul 23, 2023 100%
Amy B Mansue Individual Corporate OfficerPresident and Ceo Sep 1, 2020 100%
W-2 Managing EmployeePresident and Ceo Sep 1, 2020 100%
Operational/Managerial ControlPresident and Ceo Sep 1, 2020 100%

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Affiliated clinicians 963

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 963

NPI Registry JSON

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

{
    "created_epoch": "1315958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315958400000",
    "number": "1609158732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 IRVING AVE",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "083022123",
            "telephone_number": "856-575-4777",
            "fax_number": "856-575-4951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 TOMLIN STATION ROAD",
            "address_2": "SUITE D",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "08062",
            "telephone_number": "856-423-8633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH JERSEY HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH JERSEY HOSPITAL, INC.",
        "enumeration_date": "2011-09-14",
        "last_updated": "2011-09-14",
        "status": "A",
        "authorized_official_last_name": "DIANGELO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ALBERT",
        "authorized_official_title_or_position": "SR. VICE PRESIDENT FINANCE & CFO",
        "authorized_official_telephone_number": "856-641-8610",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": "NOT APPLICABLE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SJH Sports Rehab Care - Tomlin Station",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mullica Hill, NJ

Sources for this page

Verify at the official NPI Registry.