Organization Active NPI

Phoenix OB GYN Associates, LLC

  • Obstetrics & Gynecology Physician
  • Mount Holly, NJ
National Provider Identifier
1699701722
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
PHOENIX OB GYN ASSOCIATES, LLC
Practice address
120 Madison Ave
Suite B
Mount Holly, NJ 08060-2055
Phone
(609) 261-4925
Fax
(609) 261-9362
NPI assigned
Jun 23, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Richard Teddy Levine, M.D.NPI 1689601791
Title
Manager
Phone
(609) 261-6701

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

120 Madison Ave
Suite B
Mount Holly, NJ 08060-2055

Mailing address

120 Madison Ave
Suite B
Mount Holly, NJ 08060-2055
Phone (609) 261-4925

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699701722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 MADISON AVE",
            "address_2": "SUITE B",
            "city": "MOUNT HOLLY",
            "state": "NJ",
            "postal_code": "080602055",
            "telephone_number": "609-261-4925",
            "fax_number": "609-261-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MADISON AVE",
            "address_2": "SUITE B",
            "city": "MOUNT HOLLY",
            "state": "NJ",
            "postal_code": "080602055",
            "telephone_number": "609-261-4925",
            "fax_number": "609-261-9362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX OB GYN ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEVINE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "TEDDY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "609-261-6701",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Holly, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.