Reconstructive Orthopedics, P.a.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

RECONSTRUCTIVE ORTHOPEDICS, P.A.

Practice address

994 W Sherman Ave
Building 1
Vineland, NJ 08360-6937

Phone

(856) 696-0900

NPI assigned

Nov 12, 2014

Organization subpart

Yes

Parent organization

RECONSTRUCTIVE ORTHOPEDICS, P.A,As reported in NPPES

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

Authorized official

Name

Amy Mickle

Title

Credentialing Specialist

Phone

(609) 267-9400

Specialties & licenses 5

Addresses

Part of

Reconstructive Orthopedics PA

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.

• Reconstructive Orthopedics, P.a.

  • Orthopaedic Surgery Physician
  • Medford, NJ
  • NPI 1124526421
  NPPES parent name

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

{
    "created_epoch": "1415750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415750400000",
    "number": "1679979090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 EVES DR # A",
            "address_2": "SUITE 100",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533195",
            "telephone_number": "609-267-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "994 W SHERMAN AVE",
            "address_2": "BUILDING 1",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083606937",
            "telephone_number": "856-696-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECONSTRUCTIVE ORTHOPEDICS, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RECONSTRUCTIVE ORTHOPEDICS, P.A,",
        "enumeration_date": "2014-11-12",
        "last_updated": "2014-11-12",
        "status": "A",
        "authorized_official_last_name": "MICKLE",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "609-267-9400"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Paige Rawling, PHARMD
• Akash Ray
• Azeen Razzaq, M.D.
• Re-Medy Health & Wellness LLC
• Renee Reardon, PTA
• Recovery First LLC
• Felicia Redfern, LPN
• Kellianne Redmond, APN
• John P Reed, RPH
• Refining Health LLC

• Orthopaedic Surgery Physician in Vineland, NJ
• Providers in Vineland, NJ by specialty
• Orthopaedic Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.

Verify at the official NPI Registry.