Active NPI
Charles A Dennis, MD
- Interventional Cardiology Physician
- Moorestown, NJ
National Provider Identifier
1669436127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Cardiology Physician
- License
- 25MA05709600
- Practice address
- 401 Young Ave
Suite 275
Moorestown, NJ 08057-3130 - Phone
- (856) 291-8855
- Fax
- (856) 291-8844
- NPI assigned
- Apr 13, 2006
- Last updated
- Mar 17, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Interventional Cardiology Physician | 207RI0011X | 25MA05709600 | NJ | Primary |
Addresses
Primary practice location
401 Young Ave
Suite 275
Moorestown, NJ 08057-3130
Mailing address
7000 Atrium Way
Suite 6
Mount Laurel, NJ 08054-3917
Phone (856) 291-6818
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5038405 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Virtua Surgical Group, P.a | Past | Accepting new patients | |
| Professional Service Fund of Deborah Heart & Lung Center | Past | Accepting new patients | |
| Professional Service Fund of Deborah- Anesthesia | Past | Accepting new patients |
Organizations & group practices 3
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395014400000",
"number": "1669436127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7000 ATRIUM WAY",
"address_2": "SUITE 6",
"city": "MOUNT LAUREL",
"state": "NJ",
"postal_code": "080543917",
"telephone_number": "856-291-6818",
"fax_number": "856-291-6819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 YOUNG AVE",
"address_2": "SUITE 275",
"city": "MOORESTOWN",
"state": "NJ",
"postal_code": "080573130",
"telephone_number": "856-291-8855",
"fax_number": "856-291-8844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENNIS",
"first_name": "CHARLES",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-13",
"last_updated": "2014-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "NJ",
"license": "25MA05709600",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5038405",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Moorestown, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.