Mystic Island Pediatrics PA

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

MYSTIC ISLAND PEDIATRICS PA

Practice address

104 E Anchor Dr
Little Egg Harbor, NJ 08087-1643

Phone

(609) 294-5500

NPI assigned

Dec 27, 2006

Last updated

Aug 22, 2020By 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

Arlene Hopkins

Title

Office Manager

Phone

(609) 294-5500

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Erika Humphreys, M.D.

  • Pediatrics Physician
  • Little Egg Harbor TWP, NJ
  • NPI 1922054931
  NPD (past)

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801951892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 E ANCHOR DR",
            "city": "LITTLE EGG HARBOR",
            "state": "NJ",
            "postal_code": "080871643",
            "telephone_number": "609-294-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 E ANCHOR DR",
            "city": "LITTLE EGG HARBOR",
            "state": "NJ",
            "postal_code": "080871643",
            "telephone_number": "609-294-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYSTIC ISLAND PEDIATRICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOPKINS",
        "authorized_official_first_name": "ARLENE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "609-294-5500"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Damian Lauria, DC
• Little Egg Harbor School District
• Michael Lowe, APN
• Caroline B Mastro, MD
• Ann V Mozingo, DMD
• Mystic Pharmacy Inc
• O'Rourke Family Chiropractic , LLC
• Joseph P O'Rourke, D.C.
• Ocean Health Initiatives Inc
• Ocean Health Initiatives,Inc

• Preferred Provider Organization in Little Egg Harbor, NJ
• Providers in Little Egg Harbor, NJ by specialty
• Preferred Provider Organization in New Jersey

• 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.