Compassionate Care Oral Surgery LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

22DIO2212104 Issued in NJ

Legal business name

COMPASSIONATE CARE ORAL SURGERY LLC

Practice address

1035 N Black Horse Pike
Suite #7
Williamstown, NJ 08094-2840

Phone

(856) 740-1300

Fax

(856) 740-1302

NPI assigned

May 2, 2016

Last updated

May 2, 2016By 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. Rebekah Brevard, DMDNPI 1982607891

Title

Oral Surgeon

Phone

(609) 385-7843

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

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.

• Rebekah R Brevard, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Cape May Court House, NJ
  • NPI 1982607891
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1462147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462147200000",
    "number": "1962857573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 N BLACK HORSE PIKE",
            "address_2": "SUITE #7",
            "city": "WILLIAMSTOWN",
            "state": "NJ",
            "postal_code": "080942840",
            "telephone_number": "856-740-1300",
            "fax_number": "856-740-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 N BLACK HORSE PIKE",
            "address_2": "SUITE #7",
            "city": "WILLIAMSTOWN",
            "state": "NJ",
            "postal_code": "080942840",
            "telephone_number": "856-740-1300",
            "fax_number": "856-740-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASSIONATE CARE ORAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-02",
        "last_updated": "2016-05-02",
        "status": "A",
        "authorized_official_last_name": "BREVARD",
        "authorized_official_first_name": "REBEKAH",
        "authorized_official_title_or_position": "ORAL SURGEON",
        "authorized_official_telephone_number": "609-385-7843",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NJ",
            "license": "22DIO2212104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Williamstown, NJ
• Providers in Williamstown, NJ by specialty
• Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2016; 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.