Organization Active NPI

Moorestown Spine Sports and Wellness

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Voorhees, NJ
National Provider Identifier
1659075026
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
MOORESTOWN SPINE SPORTS AND WELLNESS
Practice address
201 White Horse Rd E
Voorhees, NJ 08043-2601
Phone
(856) 661-7900
Fax
(856) 250-1464
NPI assigned
Mar 29, 2023
Last updated
May 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Authorized official

Name
Dr. Malini M Khanna, MDNPI 1306087200
Title
President/Ceo
Phone
(202) 262-5629

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X NU Primary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X NU

Addresses

Primary practice location

201 White Horse Rd E
Voorhees, NJ 08043-2601

Mailing address

200 Marter Ave Ste 700
Moorestown, NJ 08057-3147
Phone (856) 661-7900

Other practice location 1

200 Marter Ave Ste 700
Moorestown, NJ 08057-3147
Phone (856) 661-7900

Other names 1

  • Concierge Spine and Sports Medicine Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230622000536 NJ Part B Supplier - Clinic/Group Practice 2567820665 Receives reassigned benefits from 3 practitioners
Practice locations: Moorestown, NJ

National Provider Directory

National Provider Directory

Locations

200 Marter Ave
Ste 700
Moorestown, NJ 08057
Phone (267) 551-4200

201 White Horse Rd E
Voorhees, NJ 08043
Phone (856) 661-7900

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685404800000",
    "number": "1659075026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MARTER AVE STE 700",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573147",
            "telephone_number": "856-661-7900",
            "fax_number": "856-250-1464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 WHITE HORSE RD E",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080432601",
            "telephone_number": "856-661-7900",
            "fax_number": "856-250-1464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Marter Ave Ste 700",
            "address_purpose": "LOCATION",
            "city": "Moorestown",
            "state": "NJ",
            "postal_code": "080573147",
            "country_code": "US",
            "telephone_number": "856-661-7900",
            "fax_number": "856-250-1464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOORESTOWN SPINE SPORTS AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-29",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A",
        "authorized_official_last_name": "KHANNA",
        "authorized_official_first_name": "MALINI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "202-262-5629",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Concierge Spine and Sports Medicine",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Concierge Spine and Sports Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Voorhees, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.