Organization Active NPI

Trenton Family Practice P.C.

  • Specialist
  • Trenton, NJ
National Provider Identifier
1740247964
Registry record updated Apr 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA59582 Issued in NJ
Legal business name
TRENTON FAMILY PRACTICE P.C.
Practice address
725 West Statestreet
Trenton, NJ 08618
Phone
(609) 392-2585
Fax
(609) 392-1448
NPI assigned
May 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2012

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

Authorized official

Name
Jon M. Regis, M.D.
Title
President
Phone
(609) 272-0655

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X MA59582 NJ Primary

Addresses

Primary practice location

725 West Statestreet
Trenton, NJ 08618

Mailing address

22 North Franklin Avenue
2ND Floor
Pleasantville, NJ 08232
Phone (609) 272-0655

Other identifiers 2

IdentifierTypeStateIssuer
5569702MedicaidNJ
6416802MedicaidNJ

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

725 W State St
Trenton, NJ 08618
Phone (609) 392-2250

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335744000000",
    "number": "1740247964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 NORTH FRANKLIN AVENUE",
            "address_2": "2ND FLOOR",
            "city": "PLEASANTVILLE",
            "state": "NJ",
            "postal_code": "08232",
            "telephone_number": "609-272-0655",
            "fax_number": "609-272-9317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 WEST STATESTREET",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "08618",
            "telephone_number": "609-392-2585",
            "fax_number": "609-392-1448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRENTON FAMILY PRACTICE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2012-04-30",
        "status": "A",
        "authorized_official_last_name": "REGIS",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "609-272-0655",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA59582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5569702",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6416802",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; 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.