NPIMap

Organization Active NPI

Atlanticare Physician Group PA

  • Non-Pharmacy Dispensing Site
  • Egg Harbor Township, NJ
National Provider Identifier
1922490721
Registry record updated Mar 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
25MA04005400 Issued in NJ
Legal business name
ATLANTICARE PHYSICIAN GROUP PA
Practice address
2500 English Creek Ave
BLDG 900 Suite 909
Egg Harbor Township, NJ 08234-5549
Phone
(609) 407-2273
NPI assigned
Mar 3, 2015
Organization subpart
Yes
Parent organization
MEDVANTX, INC,As reported in NPPES

Authorized official

NPPES NPI Registry
Name
Kenny Heine
Title
VP of Operations
Phone
(858) 964-1506

National Provider Directory

National Provider Directory
Tax ID family
Atlanitcare Physician Group22 organizations share this tax ID, including this one
Part of
Tri - State Medical Group Inc

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X 25MA04005400 NJ Primary

Addresses

NPPES NPI Registry

Primary practice location

2500 English Creek Ave
BLDG 900 Suite 909
Egg Harbor Township, NJ 08234-5549

Mailing address

5626 Oberlin Dr
Suite 110
San Diego, CA 92121-1705

Other names 1

NPPES NPI Registry
  • AtlantiCare Urgent Care Egg Harbor Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 3, 2015.

{
    "created_epoch": "1425340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425340800000",
    "number": "1922490721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 ENGLISH CREEK AVE",
            "address_2": "BLDG 900 SUITE 909",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082345549",
            "telephone_number": "609-407-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTICARE PHYSICIAN GROUP PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC,",
        "enumeration_date": "2015-03-03",
        "last_updated": "2015-03-03",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "858-964-1506"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NJ",
            "license": "25MA04005400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AtlantiCare Urgent Care Egg Harbor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Egg Harbor Township, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; 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.