NPIMap

Organization Active NPI

St. Luke'S Warren Physician Group, PC

  • Family Medicine Physician
  • Hampton, NJ
National Provider Identifier
1972910792
Registry record updated Mar 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST. LUKE'S WARREN PHYSICIAN GROUP, PC
Practice address
37 Rupell Rd
Hampton, NJ 08827-4017
Phone
(908) 735-7060
Fax
(908) 735-9922
NPI assigned
Jul 14, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2019

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

Authorized official

Name
Jamie Thomas, DO
Title
Vice President of Medical Affairs
Phone
(908) 847-6702

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

37 Rupell Rd
Hampton, NJ 08827-4017

Mailing address

37 Rupell Rd
Hampton, NJ 08827-4017
Phone (908) 735-7060

Other identifiers 1

IdentifierTypeStateIssuer
0029921MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031117000020 NJ Part B Supplier - Clinic/Group Practice 9739093675 Receives reassigned benefits from 664 practitioners
40 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Belvidere, NJ; Washington, NJ; Phillipsburg, NJ; Hampton, NJ; Clinton, NJ

Other NPIs on the same Medicare enrollment 40

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 40

National Provider Directory

National Provider Directory
Tax ID family
St Lukes Warren Phy GR PC18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Locations

185 Roseberry St
Phillipsburg, NJ 08865
Phone (908) 213-6611

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553644800000",
    "number": "1972910792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 RUPELL RD",
            "city": "HAMPTON",
            "state": "NJ",
            "postal_code": "088274017",
            "telephone_number": "908-735-7060",
            "fax_number": "866-289-8938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 RUPELL RD",
            "city": "HAMPTON",
            "state": "NJ",
            "postal_code": "088274017",
            "telephone_number": "908-735-7060",
            "fax_number": "908-735-9922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S WARREN PHYSICIAN GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-14",
        "last_updated": "2019-03-27",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "VICE PRESIDENT OF MEDICAL AFFAIRS",
        "authorized_official_telephone_number": "908-847-6702",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0029921",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.