Individual provider Active NPI

Gordon Lee Lerch, DO

  • Family Medicine Physician
  • Gibbsboro, NJ
National Provider Identifier
1790885275
Registry record updated Feb 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB03948400 Issued in NJ
Practice address
63 N Lakeview Dr
Suite 202
Gibbsboro, NJ 08026-1026
Phone
(856) 435-6000
Fax
(856) 782-1667
NPI assigned
Sep 24, 2006
Last updated
Feb 6, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MB03948400 NJ Primary
Pediatrics Physician 208000000X 25MB03948400 NJ

Addresses

Primary practice location

63 N Lakeview Dr
Suite 202
Gibbsboro, NJ 08026-1026

Mailing address

402 Lippincott Dr
Marlton, NJ 08053-0598
Phone (856) 782-3300

Other identifiers 1

IdentifierTypeStateIssuer
3670201MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190605000773 NJ Practitioner - Pediatric Medicine 4587997614 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
25MB03948400NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocare, LLC Family Medicine CurrentSince May 1, 2019 Accepting new patients
Advocare , LLC CurrentSince May 1, 2019 Accepting new patients
G Lee Lerch & Associates, PA Pediatrics Past Accepting new patients
Advocare, LLC Pediatrics Past Accepting new patients
G Lee Lerch & Associates, PA Pediatrics Past Accepting new patients

Locations

63 N Lakeview Dr
Ste 202
Gibbsboro, NJ 08026
Phone (856) 435-6000

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

402 Lippincott Dr
Marlton, NJ 08053
Phone (410) 763-8787

239 Hurffville Crosskeys Rd
Ste 260
Sewell, NJ 08080
Phone (856) 740-4400

Interoperability endpoints

  • Direct secure messaging: gordon.lerch@advocaredoctors.eclinicaldirectplus.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391644800000",
    "number": "1790885275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 LIPPINCOTT DR",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080530598",
            "telephone_number": "856-782-3300",
            "fax_number": "856-504-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 N LAKEVIEW DR",
            "address_2": "SUITE 202",
            "city": "GIBBSBORO",
            "state": "NJ",
            "postal_code": "080261026",
            "telephone_number": "856-435-6000",
            "fax_number": "856-782-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LERCH",
        "first_name": "GORDON",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-24",
        "last_updated": "2014-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB03948400",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MB03948400",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3670201",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gibbsboro, NJ

Sources for this page

Verify at the official NPI Registry.