Belmont Court Dialysis Center Inc

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

BELMONT COURT DIALYSIS CENTER INC

Practice address

1962 North Olden Avenue
Ewing, NJ 08618-2108

Phone

(609) 671-1600

Fax

(609) 671-9831

NPI assigned

Sep 13, 2005

Organization subpart

No

Name

Mrs. Jennifer L Bamgbose

Title

Billing Supervisor

Phone

(610) 630-1515

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 4, 2007.

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188864000000",
    "number": "1891780250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 BLVD OF THE GENERALS",
            "address_2": "EWING CAMPUS",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194033692",
            "telephone_number": "610-630-1515",
            "fax_number": "610-630-6839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1962 NORTH OLDEN AVENUE",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086182108",
            "telephone_number": "609-671-1600",
            "fax_number": "609-671-9831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELMONT COURT DIALYSIS CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-13",
        "last_updated": "2007-09-04",
        "status": "A",
        "authorized_official_last_name": "BAMGBOSE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "610-630-1515",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON BC/BS NEW JERSEY",
            "identifier": "312527",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON MERCY",
            "identifier": "1035958",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA USHEALTHCARE",
            "identifier": "550788",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "0001820000",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6812805",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Ewing, NJ
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; 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.