NPIMap

Organization Active NPI

St. Luke's Warren Physician Group, PC

  • Medical Toxicology (Emergency Medicine) Physician
  • Phillipsburg, NJ
National Provider Identifier
1689164253
Registry record updated May 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Toxicology (Emergency Medicine) PhysicianTaxonomy code 207PT0002X
Legal business name
ST. LUKE'S WARREN PHYSICIAN GROUP, PC
Practice address
185 Roseberry St
Phillipsburg, NJ 08865-1690
Phone
(484) 526-7576
Fax
(484) 526-6674
NPI assigned
May 18, 2018
Last updated
May 18, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2018

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

Authorized official

Name
Jamie Thomas, DO
Title
Owner
Phone
(908) 847-6702

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Toxicology (Emergency Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207PT0002X Primary

Addresses

Primary practice location

185 Roseberry St
Phillipsburg, NJ 08865-1690

Mailing address

185 Roseberry St
Phillipsburg, NJ 08865-1690
Phone (484) 526-7576

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040323000967 NJ Part B Supplier - Clinic/Group Practice 9739093675 Receives reassigned benefits from 216 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Phillipsburg, NJ; Washington, NJ; Hampton, NJ

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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": "1526601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526601600000",
    "number": "1689164253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 ROSEBERRY ST",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088651690",
            "telephone_number": "484-526-7576",
            "fax_number": "484-526-6674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 ROSEBERRY ST",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088651690",
            "telephone_number": "484-526-7576",
            "fax_number": "484-526-6674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S WARREN PHYSICIAN GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-18",
        "last_updated": "2018-05-18",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-847-6702",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207PT0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine, Medical Toxicology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phillipsburg, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2018; 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.