Individual provider Active NPI

John F Shulman, MD

  • Nephrology Physician
  • Philadelphia, PA
National Provider Identifier
1063512663
Registry record updated Sep 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD028728E Issued in PA
Practice address
235 N Broad St
Suite 200 Clinical Nephrology Assoc
Philadelphia, PA 19107-1511
Phone
(215) 762-7785
Fax
(215) 568-6007
NPI assigned
Sep 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD028728E PA Primary

Addresses

Primary practice location

235 N Broad St
Suite 200 Clinical Nephrology Assoc
Philadelphia, PA 19107-1511

Mailing address

235 N Broad St
Suite 200
Philadelphia, PA 19107-1511
Phone (215) 762-7785

Other identifiers 1

IdentifierTypeStateIssuer
001216365MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD028728EPAMDNephrology Physician

NPI Registry JSON

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285027200000",
    "number": "1063512663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 N BROAD ST",
            "address_2": "SUITE 200",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071511",
            "telephone_number": "215-762-7785",
            "fax_number": "215-568-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 N BROAD ST",
            "address_2": "SUITE 200 CLINICAL NEPHROLOGY ASSOC",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071511",
            "telephone_number": "215-762-7785",
            "fax_number": "215-568-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULMAN",
        "first_name": "JOHN",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-24",
        "last_updated": "2010-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MD028728E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001216365",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; 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.