Broadway Family Practice PC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

BROADWAY FAMILY PRACTICE PC

Practice address

22 N Franklin Blvd
2ND Floor
Pleasantville, NJ 08232-2547

Phone

(609) 272-0655

Fax

(609) 272-9317

NPI assigned

Jun 7, 2006

Last updated

Aug 30, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jon M. Regis, MDNPI 1508880717

Title

President

Phone

(609) 272-0655

Specialties & licenses 2

Addresses

Other identifiers 1

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• River Primary Care Center, Inc

  • General Practice Registered Nurse
  • Camden, NJ
  • NPI 1285820761

  Member Of

  NPD member

Locations

Practitioners 2

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.

• Jon M Regis, M.D.

  • Obstetrics & Gynecology Physician
  • Northfield, NJ
  • NPI 1508880717
  Authorized official Same address or phone
• Catherine Alcarez, M.D.

  • Internal Medicine Physician
  • Atlantic City, NJ
  • NPI 1326084989
  NPD (past)

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377820800000",
    "number": "1780624031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 NORTH FRANKLIN BLVD",
            "address_2": "2ND FLOOR",
            "city": "PLEASANTVILLE",
            "state": "NJ",
            "postal_code": "082322547",
            "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": "22 N FRANKLIN BLVD",
            "address_2": "2ND FLOOR",
            "city": "PLEASANTVILLE",
            "state": "NJ",
            "postal_code": "082322547",
            "telephone_number": "609-272-0655",
            "fax_number": "609-272-9317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY FAMILY PRACTICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2013-08-30",
        "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_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5569605",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bhavesh C Bhatt, PHARMACIST
• Janis Birch, RBT
• Laura J Bonaker, M.D.
• Debra Jean Boney, DIPL.AC., CA
• Brandon Tunstall LLC
• Broadway Family Practice, PC
• Koren Brown
• Tairah Brown, LCSW
• Rebekah Buccafurni, OD
• Lori A Burke, LSW

• Specialist in Pleasantville, NJ
• Providers in Pleasantville, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2013; 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.