NPI Code Detail JSON Logo

1780373803 NPI number — VIRTUA MEDICAL GROUP, PA

NPI Number: 1780373803
Health Care Provider/Practitioner: VIRTUA MEDICAL GROUP, PA

Information about “1780373803” NPI (VIRTUA MEDICAL GROUP, PA) exists in 1780373803 in HTML format HTML  |  1780373803 in plain Text format TXT  |  1780373803 in PDF (Portable Document Format) PDF  |  1780373803 in an XML format XML  formats.

NPI Number : 1780373803 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1780373803",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "VIRTUA MEDICAL GROUP, PA",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "301 LIPPINCOTT DR STE 410",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MARLTON",
    "MailingAddressStateName": "NJ",
    "MailingAddressPostalCode": "08053-4197",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "856-355-0340",
    "MailingAddressFaxNumber": "856-355-0330",
    "FirstLinePracticeLocationAddress": "243 ROUTE 130 STE 100",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BORDENTOWN",
    "PracticeLocationAddressStateName": "NJ",
    "PracticeLocationAddressPostalCode": "08505-2137",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "609-267-9400",
    "PracticeLocationAddressFaxNumber": "609-424-3517",
    "EnumerationDate": "05/04/2023",
    "LastUpdateDate": "05/30/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "MATSINGER",
    "AuthorizedOfficialFirstName": "JOHN",
    "AuthorizedOfficialMiddleName": "MARK",
    "AuthorizedOfficialTitle": "EVP AND CHIEF OPERATING OFFICER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "DO",
    "AuthorizedOfficialTelephoneNumber": "856-355-0340",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "208100000X",
          "TaxonomyName": "Physical Medicine & Rehabilitation Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2081P2900X",
          "TaxonomyName": "Pain Medicine (Physical Medicine & Rehabilitation) Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "332B00000X",
          "TaxonomyName": "Durable Medical Equipment & Medical Supplies",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363A00000X",
          "TaxonomyName": "Physician Assistant",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363AS0400X",
          "TaxonomyName": "Surgical Physician Assistant",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363L00000X",
          "TaxonomyName": "Nurse Practitioner",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207X00000X",
          "TaxonomyName": "Orthopaedic Surgery Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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