NJ South Coast Medical Center Corp

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MA09219400 Issued in NJ

Legal business name

NJ SOUTH COAST MEDICAL CENTER CORP

Practice address

37 Main St Ste 5
Clinton, NJ 08809

Phone

(609) 582-0899

NPI assigned

Oct 15, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ebere Ezeanya, MDNPI 1053547919

Title

Medical Director

Phone

(973) 704-5644

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ebere N Ezeanya, M.D.

  • Family Medicine Physician
  • Phillipsburg, NJ
  • NPI 1053547919
  Medicare reassignment Authorized official
• Kelechi Ekekwe

  • Case Manager/Care Coordinator
  • Phillipsburg, NJ
  • NPI 1922694405
  NPD
• Chykodili Jonnwakalo

  • Case Manager/Care Coordinator
  • Phillipsburg, NJ
  • NPI 1194307074
  NPD

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

{
    "created_epoch": "1381795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566345600000",
    "number": "1952739690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4995 DERBY LN",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180209418",
            "telephone_number": "973-704-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 MAIN ST STE 5",
            "city": "CLINTON",
            "state": "NJ",
            "postal_code": "08809",
            "telephone_number": "609-582-0899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 Chris Gaupp Dr",
            "address_2": "suite 100A",
            "address_purpose": "LOCATION",
            "city": "Galloway",
            "state": "NJ",
            "postal_code": "082054461",
            "country_code": "US",
            "telephone_number": "973-704-5644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NJ SOUTH COAST MEDICAL CENTER CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-15",
        "last_updated": "2019-08-21",
        "status": "A",
        "authorized_official_last_name": "EZEANYA",
        "authorized_official_first_name": "EBERE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "973-704-5644",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA09219400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0357367",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edward J Murphy, ED.D.
• Michael Murphy, PA-C
• Murray Chiropractic LLC
• John G Murray Jr., D.C.
• Margie Negri, MA PASTORAL COUNSEL
• North Hunterdon Chiropractic & Wellness Center
• North Hunterdon Dental Assoc
• Nutrition With Kyra Tywanick RDN
• Cheryl H. Orenstein, DMD
• Joni L. Owen, M.S.W., L.C.S.W.

• Family Medicine Physician in Clinton, NJ
• Providers in Clinton, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; 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.