Premier Orthopaedic & Sports Medicine Assoc of Southern NJ LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

PREMIER ORTHOPAEDIC & SPORTS MEDICINE ASSOC OF SOUTHERN NJ LLC

Practice address

556 Egg Harbor Rd Ste a
Sewell, NJ 08080-2326

Phone

(856) 690-1616

Fax

(856) 690-1089

NPI assigned

Apr 29, 2020

Organization subpart

No

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

Authorized official

Name

Verna Shepherd

Title

Administrator of Physician Services

Phone

(856) 690-1616

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1588118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588118400000",
    "number": "1750902862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 S DELSEA DR STE C",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605306",
            "telephone_number": "856-690-1616",
            "fax_number": "856-690-1089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "556 EGG HARBOR RD STE A",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802326",
            "telephone_number": "856-690-1616",
            "fax_number": "856-690-1089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER ORTHOPAEDIC & SPORTS MEDICINE ASSOC OF SOUTHERN NJ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-29",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A",
        "authorized_official_last_name": "SHEPHERD",
        "authorized_official_first_name": "VERNA",
        "authorized_official_title_or_position": "ADMINISTRATOR OF PHYSICIAN SERVICES",
        "authorized_official_telephone_number": "856-690-1616"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Portfolio One, LLC (ProMedica Skilled Nursing and Rehabilitation (Washington Township))
• Premier Brain and Spine LLC (Coastal Spine)
• Premier Brain and Spine LLC (Reclaimability Pain Services)
• Premier Eye Sewell LLC
• Premier Infusion LLC
• Adolfo E Prettelt, MD
• Samuel F Procito Jr., RPH
• Professional Healthcare Staffing
• Professional Radiation Oncology Services
• Alison Elizabeth Prudente, NP

• Orthopaedic Surgery Physician in Sewell, NJ
• Providers in Sewell, NJ by specialty
• Orthopaedic Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; 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.