John M Fanning, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS003967L Issued in PA

Practice address

8 Morton Ave
Suite 303
Ridley Park, PA 19078-2210

Phone

(610) 595-6850

Fax

(610) 595-6892

NPI assigned

Oct 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Prospect Health Access Network, Inc.

  • Emergency Medicine Physician
  • Chester, PA
  • NPI 1568819084
  Medicare reassignment NPD
• Prospect Health Access Network, Inc.

  • Diagnostic Radiology Physician
  • Chester, PA
  • NPI 1154776797

  Family Medicine

  NPD
• Cardiovascular Group LLC

  • Cardiovascular Disease Physician
  • Ridley Park, PA
  • NPI 1427050806
  NPD (past)
• Windber Hospital, Inc.

  • General Acute Care Hospital
  • Windber, PA
  • NPI 1275620536
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348185600000",
    "number": "1053494435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 MORTON AVE",
            "address_2": "SUITE 303",
            "city": "RIDLEY PARK",
            "state": "PA",
            "postal_code": "190782210",
            "telephone_number": "610-595-6850",
            "fax_number": "610-595-6892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 MORTON AVE",
            "address_2": "SUITE 303",
            "city": "RIDLEY PARK",
            "state": "PA",
            "postal_code": "190782210",
            "telephone_number": "610-595-6850",
            "fax_number": "610-595-6892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANNING",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2012-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS003967L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001454661",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brooke Dutton, OTR/L
• Lisa Jane Edwards
• Patrick L Elliott, DO
• Yasin Essa, MD
• Nkemdilim Obiorah Ezeife, M.D.
• Charlotte Fatoma
• Jennifer Lee Ferguson, CRNP
• Laura Fidorowicz, LPC
• Kristen Fridy, LPC
• Allen S Gabroy, MD

• Family Medicine Physician in Ridley Park, PA
• Providers in Ridley Park, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.