NPIMap

Organization Active NPI

New Jersey Phlebology PC

  • Phlebology Physician
  • Morristown, NJ
National Provider Identifier
1790056521
Registry record updated Jan 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebology PhysicianTaxonomy code 202K00000X
Legal business name
NEW JERSEY PHLEBOLOGY PC
Practice address
55 Madison Ave
Suite 400
Morristown, NJ 07960-7337
Phone
(630) 725-2730
Fax
(877) 219-4810
NPI assigned
Jan 25, 2012
Last updated
Jan 25, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2012

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

Authorized official

Name
J Theodore King, MD
Title
Owner
Phone
(630) 725-2768

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 202K00000X Primary

Addresses

Primary practice location

55 Madison Ave
Suite 400
Morristown, NJ 07960-7337

Mailing address

1901 Butterfield Rd
220
Downers Grove, IL 60515-7915
Phone (630) 725-2768

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1327449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327449600000",
    "number": "1790056521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 BUTTERFIELD RD",
            "address_2": "220",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605157915",
            "telephone_number": "630-725-2768",
            "fax_number": "877-219-4810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MADISON AVE",
            "address_2": "SUITE 400",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079607337",
            "telephone_number": "630-725-2730",
            "fax_number": "877-219-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW JERSEY PHLEBOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-25",
        "last_updated": "2012-01-25",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "J",
        "authorized_official_middle_name": "THEODORE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-725-2768",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Phlebology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.