NPIMap

Organization Active NPI

Shore Memorial Hospital

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Northfield, NJ
National Provider Identifier
1851384838
Registry record updated Apr 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
1084 Issued in NJ
Legal business name
SHORE MEMORIAL HOSPITAL
Practice address
2605 Shore Rd
Northfield, NJ 08225-2136
Phone
(609) 653-3454
Fax
(609) 927-8172
NPI assigned
Aug 25, 2005
Last updated
Apr 3, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2012

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

Authorized official

Name
Mr. Ronald W. Johnson, FACHE, MBA
Title
President and Ceo
Phone
(609) 653-3545

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 1084 NJ Primary

Addresses

Primary practice location

2605 Shore Rd
Northfield, NJ 08225-2136

Mailing address

1 E New York Ave
Somers Point, NJ 08244-2340
Phone (609) 653-3545

National Provider Directory

National Provider Directory
Tax ID family
Shore Memorial Hospital5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1124928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333411200000",
    "number": "1851384838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 E NEW YORK AVE",
            "city": "SOMERS POINT",
            "state": "NJ",
            "postal_code": "082442340",
            "telephone_number": "609-653-3545",
            "fax_number": "609-927-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 SHORE RD",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082252136",
            "telephone_number": "609-653-3454",
            "fax_number": "609-927-8172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-25",
        "last_updated": "2012-04-03",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "609-653-3545",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "FACHE, MBA"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NJ",
            "license": "1084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; 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.