NPIMap

Organization Active NPI

Lourdes Medical Associates, PA

  • Gastroenterology Physician
  • Willingboro, NJ
National Provider Identifier
1679866818
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
25MA02969000 Issued in NJ
Legal business name
LOURDES MEDICAL ASSOCIATES, PA
Practice address
1113 Hospital Dr
Suite 203
Willingboro, NJ 08046-1103
Phone
(609) 835-3624
Fax
(609) 835-3628
NPI assigned
May 20, 2011
Organization subpart
Yes
Parent organization
LOURDES MEDICAL ASSOCIATES, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Steven Fox, MD
Title
President
Phone
(856) 796-9200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X 25MA02969000 NJ Primary

Addresses

Primary practice location

1113 Hospital Dr
Suite 203
Willingboro, NJ 08046-1103

Mailing address

500 Grove St
Suite 100
Haddon Heights, NJ 08035-1761
Phone (856) 796-9200

Other identifiers 1

IdentifierTypeStateIssuer
6535704MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Lourdes Medical Associates PA65 organizations share this tax ID, including this one
Part of
Lourdes Medical Associates PA

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1305849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1679866818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 GROVE ST",
            "address_2": "SUITE 100",
            "city": "HADDON HEIGHTS",
            "state": "NJ",
            "postal_code": "080351761",
            "telephone_number": "856-796-9200",
            "fax_number": "856-310-0592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 HOSPITAL DR",
            "address_2": "SUITE 203",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080461103",
            "telephone_number": "609-835-3624",
            "fax_number": "609-835-3628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOURDES MEDICAL ASSOCIATES, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOURDES MEDICAL ASSOCIATES, PA",
        "enumeration_date": "2011-05-20",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-796-9200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "25MA02969000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6535704",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willingboro, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.