Organization Active NPI

Onsite Neonatal PC

  • Neonatal-Perinatal Medicine Physician
  • Voorhees, NJ
National Provider Identifier
1710404454
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
Legal business name
ONSITE NEONATAL PC
Practice address
1000 Haddonfield Berlin Road
Suite 210
Voorhees, NJ 08043-3520
Phone
(856) 782-2212
Fax
(856) 782-2218
NPI assigned
Aug 24, 2017
Organization subpart
Yes
Parent organization
ONSITE NEONATAL PCAs 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
Kelly Jack
Title
Ar Technical Manager
Phone
(856) 782-2212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080N0001X Primary

Addresses

Primary practice location

1000 Haddonfield Berlin Road
Suite 210
Voorhees, NJ 08043-3520

Mailing address

1000 Haddonfield Berlin Rd Ste 210
Voorhees, NJ 08043-3520
Phone (856) 782-2212

Other names 1

  • South Carolina Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Onsite Neonatal PC2 organizations share this tax ID, including this one
Part of
Onsite Neonatal PC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1710404454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HADDONFIELD BERLIN RD STE 210",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080433520",
            "telephone_number": "856-782-2212",
            "fax_number": "856-782-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HADDONFIELD BERLIN ROAD",
            "address_2": "SUITE 210",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080433520",
            "telephone_number": "856-782-2212",
            "fax_number": "856-782-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONSITE NEONATAL PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ONSITE NEONATAL PC",
        "enumeration_date": "2017-08-24",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "JACK",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "AR TECHNICAL MANAGER",
        "authorized_official_telephone_number": "856-782-2212"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Carolina",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Voorhees, 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.