Active NPI
Kingdom Primary Care
- Internal Medicine Physician
- Camden, NJ
National Provider Identifier
1912663584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- KINGDOM PRIMARY CARE
- Practice address
- 1300 Princess Ave
Camden, NJ 08103-2911 - Phone
- (856) 272-3600
- NPI assigned
- Nov 9, 2021
- Last updated
- Dec 3, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lauren Gotay, MD
- Title
- Provider
- Phone
- (856) 535-4100
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
1300 Princess Ave
Camden, NJ 08103-2911
Mailing address
3900 City Ave Apt W904
Philadelphia, PA 19131-2969
Other practice location 1
1300 N Orianna St
Philadelphia, PA 19122-4410
Phone (267) 845-5400
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636416000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1733184000000",
"number": "1912663584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3900 CITY AVE APT W904",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191312969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 PRINCESS AVE",
"city": "CAMDEN",
"state": "NJ",
"postal_code": "081032911",
"telephone_number": "856-272-3600"
}
],
"practiceLocations": [
{
"address_1": "1300 N Orianna St",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191224410",
"country_code": "US",
"telephone_number": "267-845-5400",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "KINGDOM PRIMARY CARE",
"organizational_subpart": "NO",
"enumeration_date": "2021-11-09",
"last_updated": "2024-12-03",
"certification_date": "2024-12-03",
"status": "A",
"authorized_official_last_name": "GOTAY",
"authorized_official_first_name": "LAUREN",
"authorized_official_title_or_position": "PROVIDER",
"authorized_official_telephone_number": "856-535-4100",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Camden, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.