South Jersey Pediatric Endocrinology, LLC

Primary specialty

Endoscopy Clinic/CenterTaxonomy code 261QE0800X

License

25MA05978100 Issued in NJ

Legal business name

SOUTH JERSEY PEDIATRIC ENDOCRINOLOGY, LLC

Doing business as

None

Practice address

6712 Washington Ave
Suite 203
Egg Harbor TWP, NJ 08234-1999

Phone

(609) 204-0698

Fax

(609) 272-3099

NPI assigned

Jan 8, 2009

Last updated

Jan 8, 2009By 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

Dr. Augustine O Chikezie, MDNPI 1669562393

Title

Medical Director

Phone

(609) 204-0698

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• None Doing business as

Locations

Practitioners 1

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.

• Augustine O. Chikezie, MD

  • Pediatric Endocrinology Physician
  • Egg Harbor TWP, NJ
  • NPI 1669562393
  Authorized official Same address or phone

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

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231372800000",
    "number": "1932346269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6712 WASHINGTON AVE",
            "address_2": "SUITE 203",
            "city": "EGG HARBOR TWP",
            "state": "NJ",
            "postal_code": "082341999",
            "telephone_number": "609-204-0698",
            "fax_number": "609-272-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6712 WASHINGTON AVE",
            "address_2": "SUITE 203",
            "city": "EGG HARBOR TWP",
            "state": "NJ",
            "postal_code": "082341999",
            "telephone_number": "609-204-0698",
            "fax_number": "609-272-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH JERSEY PEDIATRIC ENDOCRINOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-08",
        "last_updated": "2009-01-08",
        "status": "A",
        "authorized_official_last_name": "CHIKEZIE",
        "authorized_official_first_name": "AUGUSTINE",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "609-204-0698",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "NJ",
            "license": "25MA05978100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7848803",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "None",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Endoscopy Clinic/Center in Egg Harbor TWP, NJ
• Providers in Egg Harbor TWP, NJ by specialty
• Endoscopy Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; 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.