Organization Active NPI

Westfield Avenue Medical Center

  • Family Medicine Physician
  • Camden, NJ
National Provider Identifier
1629006200
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MB52022 Issued in NJ
Legal business name
WESTFIELD AVENUE MEDICAL CENTER
Practice address
3113 Westfield Ave
Camden, NJ 08105-2412
Phone
(856) 963-0739
NPI assigned
Jun 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Morris Peterzell, D.O.
Title
President
Phone
(856) 963-0739

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X MB52022 NJ Primary

Addresses

Primary practice location

3113 Westfield Ave
Camden, NJ 08105-2412

Mailing address

PO Box 1966
Camden, NJ 08101-1966
Phone (856) 963-0739

Other identifiers 1

IdentifierTypeStateIssuer
8831408MedicaidNJ

National Provider Directory

National Provider Directory

Locations

3113 Westfield Ave
Camden, NJ 08105
Phone (609) 963-0739

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629006200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1966",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081011966",
            "telephone_number": "856-963-0739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 WESTFIELD AVE",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081052412",
            "telephone_number": "856-963-0739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTFIELD AVENUE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETERZELL",
        "authorized_official_first_name": "MORRIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-963-0739",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB52022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8831408",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.