South Jersey Gastroenterology, PA

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

SOUTH JERSEY GASTROENTEROLOGY, PA

Practice address

406 Lippincott Dr
Suite E
Marlton, NJ 08053-4168

Phone

(856) 983-1900

Fax

(856) 983-1914

NPI assigned

Jun 16, 2006

Last updated

Sep 26, 2013By 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

Steven Liakos, D.O.NPI 1295713212

Title

President

Phone

(856) 983-1900

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• South Jersey Gastroenterology PA

  • Anesthesiology Physician
  • Voorhees, NJ
  • NPI 1356514335

  O20071219000019

  Same enrollment

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• South Jersey Gastroenterology PA

  • Anesthesiology Physician
  • Voorhees, NJ
  • NPI 1356514335
  NPPES parent name

Practitioners 2

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.

• Steven Liakos, D.O.

  • Gastroenterology Physician
  • Marlton, NJ
  • NPI 1295713212
  Authorized official Same address or phone
• Stacey Rene Zavala, MD

  • Gastroenterology Physician
  • Marlton, NJ
  • NPI 1144433673
  NPD

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380153600000",
    "number": "1871537225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 LIPPINCOTT DR",
            "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 DR",
            "address_2": "SUITE E",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534168",
            "telephone_number": "856-983-1900",
            "fax_number": "856-983-1914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH JERSEY GASTROENTEROLOGY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2013-09-26",
        "status": "A",
        "authorized_official_last_name": "LIAKOS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-983-1900",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3047407",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sound Mind Counseling Center, LLC
• Sound Minds Counseling LLC
• South Jersey Center for Advanced Dentistry, LLC (SJ Center for Advanced Dentistry)
• South Jersey Coping Clinic LLC
• South Jersey Fertility, LLC
• South Jersey Pain Consultants LLC
• South Jersey Pain Consultants, LLC
• South Jersey Skin Care & Laser Center, P.C.
• South Jersey Sports & Spine Medicine LLC
• South Jersey Urogynecology, LLC

• Gastroenterology Physician in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Gastroenterology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.