NPIMap

Organization Active NPI

St. Luke'S Warren Physician Group, PC

  • Family Medicine Physician
  • Belvidere, NJ
National Provider Identifier
1780162396
Registry record updated Aug 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST. LUKE'S WARREN PHYSICIAN GROUP, PC
Practice address
187 County Road 519 Ste 2
Belvidere, NJ 07823
Phone
(908) 847-3991
Fax
(833) 541-5800
NPI assigned
Aug 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2018

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

Authorized official

Name
Jamie Thomas
Title
Owner
Phone
(908) 847-6702

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

187 County Road 519 Ste 2
Belvidere, NJ 07823

Mailing address

185 Roseberry St
2ND Floor Farley BLDG
Phillipsburg, NJ 08865
Phone (908) 847-2621

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040510000536 NJ Part B Supplier - Clinic/Group Practice 9739093675 Receives reassigned benefits from 18 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Belvidere, NJ; Washington, NJ

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
St Lukes Warren Phy GR PC18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535587200000",
    "number": "1780162396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 ROSEBERRY ST",
            "address_2": "2ND FLOOR FARLEY BLDG",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "08865",
            "telephone_number": "908-847-2621",
            "fax_number": "908-847-3045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 COUNTY ROAD 519 STE 2",
            "city": "BELVIDERE",
            "state": "NJ",
            "postal_code": "07823",
            "telephone_number": "908-847-3991",
            "fax_number": "833-541-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S WARREN PHYSICIAN GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-06",
        "last_updated": "2018-08-30",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-847-6702"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belvidere, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; 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.