NPIMap

Organization Active NPI

Our Lady of Lourdes Medical Center, Inc

  • Family Medicine Physician
  • Collingswood, NJ
National Provider Identifier
1811020654
Registry record updated Jan 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA04483700 Issued in NJ
Legal business name
OUR LADY OF LOURDES MEDICAL CENTER, INC
Practice address
900 Haddon Ave
Suite 136
Collingswood, NJ 08108-2101
Phone
(856) 869-3126
Fax
(856) 833-2050
NPI assigned
Mar 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2018

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

Authorized official

Name
Ms. Kathryn L Friedman
Title
Director, Integrative Health Care
Phone
(856) 833-2052

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 25MA04483700 NJ Primary

Addresses

Primary practice location

900 Haddon Ave
Suite 136
Collingswood, NJ 08108-2101

Mailing address

900 Haddon Ave
Suite 136
Collingswood, NJ 08108-2101
Phone (856) 869-3126

Other identifiers 1

IdentifierTypeStateIssuer
25MA04483700OtherNJSTATE MED LICENSE #

National Provider Directory

National Provider Directory
Tax ID family
Lourdes Surgical Associates7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515024000000",
    "number": "1811020654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 HADDON AVE",
            "address_2": "SUITE 136",
            "city": "COLLINGSWOOD",
            "state": "NJ",
            "postal_code": "081082101",
            "telephone_number": "856-869-3126",
            "fax_number": "856-833-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 HADDON AVE",
            "address_2": "SUITE 136",
            "city": "COLLINGSWOOD",
            "state": "NJ",
            "postal_code": "081082101",
            "telephone_number": "856-869-3126",
            "fax_number": "856-833-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY OF LOURDES MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2018-01-04",
        "status": "A",
        "authorized_official_last_name": "FRIEDMAN",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR, INTEGRATIVE HEALTH CARE",
        "authorized_official_telephone_number": "856-833-2052",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA04483700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MED LICENSE #",
            "identifier": "25MA04483700",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Collingswood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2018; 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.