NPIMap

Organization Active NPI

Infectious Disease Consultants of South Jersey LLC

  • Infectious Disease Physician
  • Browns Mills, NJ
National Provider Identifier
1639448806
Registry record updated Dec 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
25MA02594500 Issued in NJ
Legal business name
INFECTIOUS DISEASE CONSULTANTS OF SOUTH JERSEY LLC
Practice address
200 Trenton Rd
Browns Mills, NJ 08015-1705
Phone
(609) 677-1046
Fax
(609) 677-1306
NPI assigned
Dec 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2011

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

Authorized official

Name
Lynn Carpenter, RN
Title
Office Manager
Phone
(609) 677-1046

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X 25MA02594500 NJ Primary

Addresses

Primary practice location

200 Trenton Rd
Browns Mills, NJ 08015-1705

Mailing address

PO Box 1283
Medford, NJ 08055-6283
Phone (609) 677-1046

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.

NPI Registry JSON

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

{
    "created_epoch": "1324166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324166400000",
    "number": "1639448806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1283",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080556283",
            "telephone_number": "609-677-1046",
            "fax_number": "609-677-1306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 TRENTON RD",
            "city": "BROWNS MILLS",
            "state": "NJ",
            "postal_code": "080151705",
            "telephone_number": "609-677-1046",
            "fax_number": "609-677-1306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFECTIOUS DISEASE CONSULTANTS OF SOUTH JERSEY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-18",
        "last_updated": "2011-12-18",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "609-677-1046",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NJ",
            "license": "25MA02594500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Browns Mills, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2011; 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.