Individual provider Active NPI

Herbert C. Conaway Jr., M.D.

  • Internal Medicine Physician
  • Delran, NJ
National Provider Identifier
1649387283
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA56855 Issued in NJ
Practice address
26 Waters Edge Dr
Delran, NJ 08075-1898
Phone
(609) 456-0039
Fax
(888) 585-0180
NPI assigned
Aug 23, 2006
Last updated
Aug 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA56855 NJ Primary

Addresses

Primary practice location

26 Waters Edge Dr
Delran, NJ 08075-1898

Mailing address

26 Waters Edge Dr
Delran, NJ 08075-1898
Phone (609) 456-0039

Other identifiers 1

IdentifierTypeStateIssuer
8678600MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060110000928 NJ Practitioner - Internal MedicinePractitioner - General Practice 0840213377 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA56855NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Herbert C. Conaway, Jr., M.D., L.L.C. Internal Medicine CurrentSince Aug 13, 2023 Accepting new patients
Cooper Physician Offices, PA Internal Medicine CurrentSince Dec 1, 2005 Accepting new patients

Locations

1210 Brace Rd
Cherry Hill, NJ 08034
Phone (609) 428-6616

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1649387283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 WATERS EDGE DR",
            "city": "DELRAN",
            "state": "NJ",
            "postal_code": "080751898",
            "telephone_number": "609-456-0039",
            "fax_number": "888-585-0180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 WATERS EDGE DR",
            "city": "DELRAN",
            "state": "NJ",
            "postal_code": "080751898",
            "telephone_number": "609-456-0039",
            "fax_number": "888-585-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONAWAY",
        "first_name": "HERBERT",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA56855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8678600",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Delran, NJ

Sources for this page

Verify at the official NPI Registry.