NPIMap

Organization Active NPI

Fornance Physician Services, Inc

  • Neurology Physician
  • Plymouth Meeting, PA
National Provider Identifier
1013601541
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
FORNANCE PHYSICIAN SERVICES, INC
Practice address
633 W Germantown Pike Ste 105
Plymouth Meeting, PA 19462-1032
Phone
(610) 941-6881
Fax
(610) 941-6635
NPI assigned
Jun 7, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Authorized official

Name
Tiffany Jones
Title
Provider Enrollment Manager
Phone
(215) 456-8129

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurocritical Care PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084A2900X
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X Primary
Vascular Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084V0102X

Addresses

Primary practice location

633 W Germantown Pike Ste 105
Plymouth Meeting, PA 19462-1032

Mailing address

PO Box 789967
Philadelphia, PA 19178-9967
Phone (484) 622-7395

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040216000037 PA Part B Supplier - Clinic/Group Practice 8527962661 Receives reassigned benefits from 215 practitioners
36 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: King of Prussia, PA; Lansdale, PA; Norristown, PA; North Wales, PA; Plymouth Meeting, PA; East Norriton, PA; Audubon, PA; Blue Bell, PA…

Other NPIs on the same Medicare enrollment 36

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

View all 36

National Provider Directory

National Provider Directory
Tax ID family
Fornance Physician Services Inc28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1686096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686614400000",
    "number": "1013601541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 789967",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191789967",
            "telephone_number": "484-622-7395",
            "fax_number": "414-622-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 W GERMANTOWN PIKE STE 105",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621032",
            "telephone_number": "610-941-6881",
            "fax_number": "610-941-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORNANCE PHYSICIAN SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-07",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "215-456-8129"
    },
    "taxonomies": [
        {
            "code": "2084A2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth Meeting, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; 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.