NPIMap

Organization Active NPI

Phoenix Behavioral Health LLC

  • Developmental - Behavioral Pediatrics Physician
  • Ewing, NJ
National Provider Identifier
1750891990
Registry record updated Oct 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
Legal business name
PHOENIX BEHAVIORAL HEALTH LLC
Practice address
1014 Whitehead Road Ext
Ewing, NJ 08638-2406
Phone
(609) 771-3777
NPI assigned
Oct 2, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2017

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

Authorized official

Name
Phil Fuhrer
Title
Cfo
Phone
(609) 771-3777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0006X Primary

Addresses

Primary practice location

1014 Whitehead Road Ext
Ewing, NJ 08638-2406

Mailing address

1014 Whitehead Road Ext
Ewing, NJ 08638-2406
Phone (609) 771-3777

Other identifiers 1

IdentifierTypeStateIssuer
0468665MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Phoenix Behavioral Health9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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": "1506902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506902400000",
    "number": "1750891990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 WHITEHEAD ROAD EXT",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086382406",
            "telephone_number": "609-771-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 WHITEHEAD ROAD EXT",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086382406",
            "telephone_number": "609-771-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-02",
        "last_updated": "2017-10-02",
        "status": "A",
        "authorized_official_last_name": "FUHRER",
        "authorized_official_first_name": "PHIL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "609-771-3777"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0468665",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ewing, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2017; 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.