NPIMap

Organization Active NPI

Pediatric Associates LLC

  • Pediatrics Physician
  • Vineland, NJ
National Provider Identifier
1790868503
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC ASSOCIATES LLC
Practice address
1318 S Main Road
Vineland, NJ 08360
Phone
(856) 691-8585
Fax
(856) 691-8489
NPI assigned
Oct 23, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Beth E Lorentz
Title
Practice Manager
Phone
(856) 691-8585

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NJ Primary

Addresses

Primary practice location

1318 S Main Road
Vineland, NJ 08360

Mailing address

1318 S Main Road
Vineland, NJ 08360
Phone (856) 691-8585

Other identifiers 1

IdentifierTypeStateIssuer
4525604MedicaidNJ

National Provider Directory

National Provider Directory

Locations

1318 S Main Rd
Vineland, NJ 08360
Phone (856) 462-6350

1318 S Main Rd
Bldg 1
Vineland, NJ 08360
Phone (856) 691-8585

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790868503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 S MAIN ROAD",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "08360",
            "telephone_number": "856-691-8585",
            "fax_number": "856-691-8489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1318 S MAIN ROAD",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "08360",
            "telephone_number": "856-691-8585",
            "fax_number": "856-691-8489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LORENTZ",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "856-691-8585",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4525604",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.