Active NPI
Jack L Solomon, M.D.
- Psychiatry Physician
- Narberth, PA
National Provider Identifier
1003196346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD006986E
- Practice address
- 1500 Flat Rock Road
Narberth, PA 19072-1228 - Phone
- (610) 617-7291
- NPI assigned
- Aug 18, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD006986E | PA | Primary |
Addresses
Primary practice location
1500 Flat Rock Road
Narberth, PA 19072-1228
Mailing address
1500 Flat Rock Road
Narberth, PA 19072-1228
Phone (610) 617-7291
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 14, 2020 through Jan 14, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD006986E | PA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313625600000",
"number": "1003196346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 FLAT ROCK ROAD",
"city": "NARBERTH",
"state": "PA",
"postal_code": "190721228",
"telephone_number": "610-617-7291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 FLAT ROCK ROAD",
"city": "NARBERTH",
"state": "PA",
"postal_code": "190721228",
"telephone_number": "610-617-7291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOLOMON",
"first_name": "JACK",
"middle_name": "L",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-08-18",
"last_updated": "2011-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MD006986E",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Narberth, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.