Active NPI
Michele Marie Anthony, M.D.
- Internal Medicine Physician
- Vineland, NJ
National Provider Identifier
1720006133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 25MA04974000
- Practice address
- 524 N West Blvd
Vineland, NJ 08360-2845 - Phone
- (856) 405-4200
- Fax
- (856) 696-6714
- NPI assigned
- Jul 17, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 25MA04974000 | NJ | Primary |
Addresses
Primary practice location
524 N West Blvd
Vineland, NJ 08360-2845
Mailing address
524 N West Blvd
Vineland, NJ 08360-2845
Phone (856) 405-4200
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4472004 | Medicaid | NJ | |
| 638547B1G | Other | NJ | MEDICARE BILLING NO. |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA04974000 | NJ | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310083200000",
"number": "1720006133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "524 N WEST BLVD",
"city": "VINELAND",
"state": "NJ",
"postal_code": "083602845",
"telephone_number": "856-405-4200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "524 N WEST BLVD",
"city": "VINELAND",
"state": "NJ",
"postal_code": "083602845",
"telephone_number": "856-405-4200",
"fax_number": "856-696-6714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTHONY",
"first_name": "MICHELE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-17",
"last_updated": "2011-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NJ",
"license": "25MA04974000",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4472004",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE BILLING NO.",
"identifier": "638547B1G",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Vineland, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.