Individual provider Active NPI

Robert Davis, D.O.

  • Family Medicine Physician
  • Voorhees, NJ
National Provider Identifier
1720068851
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB0570440 Issued in NJ
Practice address
1605 E Evesham Rd Ste 100a
Voorhees, NJ 08043-1437
Phone
(856) 741-7100
Fax
(856) 424-2629
NPI assigned
Jan 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MB0570440 NJ Primary

Addresses

Primary practice location

1605 E Evesham Rd Ste 100a
Voorhees, NJ 08043-1437

Mailing address

701 Cooper Rd
Suite 16
Voorhees, NJ 08043-3800
Phone (856) 783-5000

Other practice location 1

94 Brick Rd
Suite 105
Marlton, NJ 08053-2179
Phone (856) 988-0444

Other identifiers 1

IdentifierTypeStateIssuer
5510503MedicaidNJ

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rdavis12771@directvirtua.org
Direct Messaging Address rdavis12771@directvirtua.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070306000504 NJ Practitioner - Family Practice 1355444738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

2309 E Evesham Rd
Voorhees, NJ 08043-1559

3242 Route 206
Bordentown, NJ 08505-4517

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MB0570440NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA Family Medicine CurrentSince Jun 1, 2014 Accepting new patients
Virtua Medical Group, PA CurrentSince Jun 1, 2014 Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

141 Route 70 E
Ste E
Marlton, NJ 08053
Phone (856) 985-7373

7000 Atrium Way
Ste 6
Mount Laurel, NJ 08054
Phone (856) 206-4500

701 Cooper Rd
Ste 16
Voorhees, NJ 08043
Phone (856) 429-2224

1605 E Evesham Rd
Ste 100A
Voorhees, NJ 08043
Phone (856) 741-7100

Interoperability endpoints

  • Direct secure messaging: rdavis12771@directvirtua.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1720068851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 COOPER RD",
            "address_2": "SUITE 16",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080433800",
            "telephone_number": "856-783-5000",
            "fax_number": "856-783-5041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 E EVESHAM RD STE 100A",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080431437",
            "telephone_number": "856-741-7100",
            "fax_number": "856-424-2629"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "94 Brick Rd",
            "address_2": "Suite 105",
            "address_purpose": "LOCATION",
            "city": "Marlton",
            "state": "NJ",
            "postal_code": "080532179",
            "country_code": "US",
            "telephone_number": "856-988-0444",
            "fax_number": "856-988-9645",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB0570440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5510503",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rdavis12771@directvirtua.org",
            "affiliation": "N",
            "address_1": "94 Brick Rd",
            "address_2": "Suite 105",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080532179",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rdavis12771@directvirtua.org",
            "affiliation": "N",
            "address_1": "1605 E Evesham Rd Ste 100A",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080431437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

Verify at the official NPI Registry.