Pinelands Pediatric Medicine LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MB08379900 Issued in NJ

Legal business name

PINELANDS PEDIATRIC MEDICINE LLC

Practice address

1303 Liberty PL
Sicklerville, NJ 08081-5710

Phone

(856) 885-4854

Fax

(856) 885-4896

NPI assigned

May 16, 2016

Last updated

May 16, 2016By 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. Sharon Kaus, DONPI 1003083312

Title

Owner

Phone

(856) 885-4854

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

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.

• Sharon M Kaus, DO

  • Pediatrics Physician
  • Sicklerville, NJ
  • NPI 1003083312
  NPD (past) Authorized official
• Kathryn Stuffo, D.O.

  • Pediatrics Physician
  • Sicklerville, NJ
  • NPI 1316280043
  NPD (past)
• Athena Maria Yudin

  • Pediatrics Physician
  • Marlton, NJ
  • NPI 1174171086
  NPD (past)

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

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463356800000",
    "number": "1790132140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 LIBERTY PL",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080815710",
            "telephone_number": "856-885-4854",
            "fax_number": "856-885-4896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 LIBERTY PL",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080815710",
            "telephone_number": "856-885-4854",
            "fax_number": "856-885-4896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINELANDS PEDIATRIC MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-16",
        "last_updated": "2016-05-16",
        "status": "A",
        "authorized_official_last_name": "KAUS",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-885-4854",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MB08379900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167193",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Phillips
• Stephen Michael Phillips, R.PH.
• Melvin Keith Pierson, D.D.S.
• Natalie Williams Pierson, RN
• Nicol Pilic, PHARM D
• Angelic Pless
• Point a to Point B Transport, LLC
• Nasheeda Pollard, IBCLC
• Leann Poole
• Kimberly Jordan Pratt, M.S., CCC-SLP

• Pediatrics Physician in Sicklerville, NJ
• Providers in Sicklerville, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.