NPIMap

Organization Active NPI

Vital Medical Forces of Denville PC

  • Internal Medicine Physician
  • Denville, NJ
National Provider Identifier
1639198617
Registry record updated Aug 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
VITAL MEDICAL FORCES OF DENVILLE PC
Practice address
25 Pocono Rd
Denville, NJ 07834
Phone
(973) 989-3085
Fax
(973) 989-3106
NPI assigned
Jul 19, 2006
Last updated
Aug 7, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2007

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

Authorized official

Name
Mary L Carlson
Title
Office Manager
Phone
(973) 989-3085

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

25 Pocono Rd
Denville, NJ 07834

Mailing address

PO Box 37
Denville, NJ 07834
Phone (973) 989-3085

Other identifiers 1

IdentifierTypeStateIssuer
0097390MedicaidNJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186444800000",
    "number": "1639198617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37",
            "city": "DENVILLE",
            "state": "NJ",
            "postal_code": "07834",
            "telephone_number": "973-989-3085",
            "fax_number": "973-989-3106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 POCONO RD",
            "city": "DENVILLE",
            "state": "NJ",
            "postal_code": "07834",
            "telephone_number": "973-989-3085",
            "fax_number": "973-989-3106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL MEDICAL FORCES OF DENVILLE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-08-07",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "973-989-3085"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0097390",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2007; 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.