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FAMILY PRACTICE MEDICAL
NPI 1194882183
Family Medicine - Geriatric Medicine in Mount Laurel, NJ

Active since January 02, 2007CLIA 31D0117085 · Waiver
3814 CHURCH RD, MOUNT LAUREL, NJ 08054(856) 231-9792 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Family Practice Medical NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAMILY PRACTICE MEDICAL (NPI 1194882183) is a healthcare organization registered as a geriatric medicine in Mount Laurel, New Jersey and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Peggy A Kelly, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1194882183
Entity TypeOrganization
Primary Taxonomy207QG0300X
Legal Business NameFAMILY PRACTICE MEDICAL
Location Address3814 CHURCH RDMount Laurel, NJ 08054-1106
Mailing Address3814 Church RdMount Laurel, NJ 08054-1106 · (856) 231-9792
Phone(856) 231-9792
Organization SubpartNo
Authorized OfficialPeggy A KellyOffice Manager · (856) 231-9792
Enumeration DateJanuary 2, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1194882183 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QG0300X
License✔ Licensed in NJ · MB44700
Definition
A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.
3814 CHURCH RD, Mount Laurel, NJ 08054
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 31D0117085

Family Practice Medical Assoc PC · Mount Laurel, NJ
Active · expires Aug 31, 2026
CLIA Number31D0117085
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorFrank P. Pettinelli Jr Do
Laboratory Phone(609) 667-4448
Laboratory LocationFamily Practice Medical Assoc PC3814 Church Rd, Mount Laurel, NJ 08054
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. FRANK P PETTINELLI D.O.
Family Medicine
3814 CHURCH RD
MOUNT LAUREL, NJ 08054
Burlington County (856) 231-9792

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Family Practice Medical's NPI number?

The NPI number for Family Practice Medical is 1194882183. It was assigned to this organization in the NPPES registry on January 2, 2007.

Where is Family Practice Medical located?

Family Practice Medical is located at 3814 Church Rd, Mount Laurel, NJ 08054. The listed phone number is (856) 231-9792.

What is Family Practice Medical's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Geriatric Medicine, with taxonomy code 207QG0300X.

Does Family Practice Medical hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 31D0117085) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Family Practice Medical was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.