NPIMap

Organization Active NPI

Life Choice Hospice of New Jersey, LLC

Doing business as Compassus Palliative Care - New Jersey

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Willingboro, NJ
National Provider Identifier
1730653213
Registry record updated Jun 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
Legal business name
LIFE CHOICE HOSPICE OF NEW JERSEY, LLC
Doing business as
Compassus Palliative Care - New Jersey
Practice address
4390 Route 130 Ste a
Willingboro, NJ 08046-1065
Phone
(267) 781-7315
Fax
(800) 783-7854
NPI assigned
Jan 17, 2019
Last updated
Jun 21, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2019

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

Authorized official

Name
Russell Adkins
Title
SVP General Counsel
Phone
(615) 309-5668

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X NU Primary

Addresses

Primary practice location

4390 Route 130 Ste a
Willingboro, NJ 08046-1065

Mailing address

10 Cadillac Dr Ste 400
Brentwood, TN 37027-1001
Phone (615) 377-7022

Other names 1

  • Compassus Palliative Care - New Jersey Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190227001153 NJ Part B Supplier - Clinic/Group Practice 9638207715 Receives reassigned benefits from 11 practitioners
Practice locations: Willingboro, NJ

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Life Choice Hospice of New Jersey LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

3219 Route 46
Ste 206
Parsippany, NJ 07054
Phone (201) 843-8490

65 State Rt 4
Ste 2
River Edge, NJ 07661
Phone (201) 880-6577

222 Oak Ave
Fl 3
Toms River, NJ 08753
Phone (732) 722-5001

1955 State Route 34
Ste 1A
Wall Township, NJ 07719
Phone (267) 781-0944

200 Campbell Dr
Ste 106
Willingboro, NJ 08046
Phone (267) 781-7315

4390 Route 130
Ste A
Willingboro, NJ 08046
Phone (267) 781-7315

Practitioners & affiliated clinicians

Practitioners 11

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": "1547683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561075200000",
    "number": "1730653213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CADILLAC DR STE 400",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370271001",
            "telephone_number": "615-377-7022",
            "fax_number": "615-373-4457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4390 ROUTE 130 STE A",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080461065",
            "telephone_number": "267-781-7315",
            "fax_number": "800-783-7854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CHOICE HOSPICE OF NEW JERSEY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-17",
        "last_updated": "2019-06-21",
        "status": "A",
        "authorized_official_last_name": "ADKINS",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "SVP GENERAL COUNSEL",
        "authorized_official_telephone_number": "615-309-5668"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Compassus Palliative Care - New Jersey",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Compassus Palliative Care - New Jersey",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Willingboro, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2019; 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.