NPIMap

Organization Active NPI

Life St. Mary

  • PACE Provider Organization
  • Trevose, PA
National Provider Identifier
1003052820
Registry record updated Apr 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PACE Provider OrganizationTaxonomy code 251T00000X
Legal business name
LIFE ST. MARY
Practice address
2500 Interplex Drive
Trevose, PA 19053-6943
Phone
(215) 710-6114
NPI assigned
Dec 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2009

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

Authorized official

Name
Ms. Emily Amerman, MSW
Title
Executive Director
Phone
(215) 710-6114

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PACE Provider Organization 251T00000X Primary
Adult Day Care Clinic/Center 261QA0600X

Addresses

Primary practice location

2500 Interplex Drive
Trevose, PA 19053-6943

Mailing address

1201 Langhorne-Newtown Rd.
Langhorne, PA 19047-1201
Phone (215) 710-6114

Other identifiers 1

IdentifierTypeStateIssuer
H6551OtherCMS

National Provider Directory

National Provider Directory

Locations

2500 Neshaminy Interplex Dr
Trevose, PA 19053
Phone (267) 991-7601

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1230508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240272000000",
    "number": "1003052820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 LANGHORNE-NEWTOWN RD.",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190471201",
            "telephone_number": "215-710-6114",
            "fax_number": "215-710-2298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 INTERPLEX DRIVE",
            "city": "TREVOSE",
            "state": "PA",
            "postal_code": "190536943",
            "telephone_number": "215-710-6114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE ST. MARY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-29",
        "last_updated": "2009-04-21",
        "status": "A",
        "authorized_official_last_name": "AMERMAN",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "215-710-6114",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS",
            "identifier": "H6551",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trevose, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2009; 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.