Organization Active NPI

Southampton Psychiatric Associates PC

  • Psychiatry Physician
  • Southampton, PA
National Provider Identifier
1013926583
Registry record updated Oct 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SOUTHAMPTON PSYCHIATRIC ASSOCIATES PC
Practice address
1111 Street Rd
Suite 312
Southampton, PA 18966-4250
Phone
(215) 355-2011
Fax
(215) 396-1886
NPI assigned
Aug 5, 2006
Last updated
Oct 8, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2007

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

Authorized official

Name
Denise Beard
Title
Office Manager
Phone
(215) 355-2011

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NU
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

1111 Street Rd
Suite 312
Southampton, PA 18966-4250

Mailing address

1111 Street Rd
Suite 312
Southampton, PA 18966-4250
Phone (215) 355-2011

Other identifiers 3

IdentifierTypeStateIssuer
779800OtherHIGHMARK
0977468000OtherIBC
37920OtherHIGHMARK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040721000569 PA Part B Supplier - Clinic/Group Practice 3971583949 Receives reassigned benefits from 7 practitioners
Practice locations: Ivyland, PA

National Provider Directory

National Provider Directory

Locations

1111 Street Rd
Ste 312
Southampton, PA 18966
Phone (215) 355-2011

882 Jacksonville Rd
Ste 205
Warminster, PA 18974
Phone (215) 355-2011

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191801600000",
    "number": "1013926583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 STREET RD",
            "address_2": "SUITE 312",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189664250",
            "telephone_number": "215-355-2011",
            "fax_number": "215-396-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 STREET RD",
            "address_2": "SUITE 312",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189664250",
            "telephone_number": "215-355-2011",
            "fax_number": "215-396-1886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHAMPTON PSYCHIATRIC ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-10-08",
        "status": "A",
        "authorized_official_last_name": "BEARD",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "215-355-2011"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "779800",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "0977468000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "37920",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southampton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2007; 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.