NPIMap

Organization Active NPI

Wild Surgical Services LLC

  • General Acute Care Hospital
  • Port Republic, NJ
National Provider Identifier
1972761138
Registry record updated May 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
WILD SURGICAL SERVICES LLC
Practice address
321 English Creek Rd
Port Republic, NJ 08241-9794
Phone
(609) 652-1276
Fax
(609) 652-7498
NPI assigned
May 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2008

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

Authorized official

Name
Mary K Wild, RN CRNFA
Title
Owner
Phone
(609) 350-2211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

321 English Creek Rd
Port Republic, NJ 08241-9794

Mailing address

321 English Creek Rd
Port Republic, NJ 08241-9794
Phone (609) 652-1276

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211500800000",
    "number": "1972761138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 ENGLISH CREEK RD",
            "city": "PORT REPUBLIC",
            "state": "NJ",
            "postal_code": "082419794",
            "telephone_number": "609-652-1276",
            "fax_number": "609-652-7498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 ENGLISH CREEK RD",
            "city": "PORT REPUBLIC",
            "state": "NJ",
            "postal_code": "082419794",
            "telephone_number": "609-652-1276",
            "fax_number": "609-652-7498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILD SURGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-23",
        "last_updated": "2008-05-23",
        "status": "A",
        "authorized_official_last_name": "WILD",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-350-2211",
        "authorized_official_credential": "RN CRNFA"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Republic, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; 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.