Individual provider Active NPI

Steven Davidoff, MD

  • Gastroenterology Physician
  • Marlton, NJ
National Provider Identifier
1841250685
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
25MA03614900 Issued in NJ
Practice address
406 Lippincott Drive
Suite E
Marlton, NJ 08053-4168
Phone
(856) 983-1900
Fax
(856) 983-1914
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 03614900 NJ
Gastroenterology Physician 207RG0100X 25MA03614900 NJ Primary

Addresses

Primary practice location

406 Lippincott Drive
Suite E
Marlton, NJ 08053-4168

Mailing address

406 Lippincott Drive
Suite E
Marlton, NJ 08053-4168
Phone (856) 983-1900

Other identifiers 1

IdentifierTypeStateIssuer
4728009MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
03614900NJMDGastroenterology Physician

Interoperability endpoints

  • Direct secure messaging: steven.davidoff@southjerseygastroenterology.chartmakerdirect.com

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1841250685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 LIPPINCOTT DRIVE",
            "address_2": "SUITE E",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534168",
            "telephone_number": "856-983-1900",
            "fax_number": "856-983-1914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 LIPPINCOTT DRIVE",
            "address_2": "SUITE E",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534168",
            "telephone_number": "856-983-1900",
            "fax_number": "856-983-1914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDOFF",
        "first_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "03614900",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "25MA03614900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4728009",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; 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.