Active NPI
Mariah Everett
- Pediatrics Physician
- Philadelphia, PA
National Provider Identifier
1073308359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MT233388
- Practice address
- 3401 Civic Center Blvd
Division of General Pediatrics
Philadelphia, PA 19104-4319 - Phone
- (215) 590-1220
- NPI assigned
- Apr 9, 2025
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MT233388 | PA | Primary |
Addresses
Primary practice location
3401 Civic Center Blvd
Division of General Pediatrics
Philadelphia, PA 19104-4319
Mailing address
3813 Smith Ave SE
Albuquerque, NM 87108-4345
Phone (505) 453-7993
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT233388 | PA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748217600000",
"number": "1073308359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3813 SMITH AVE SE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871084345",
"telephone_number": "505-453-7993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"address_2": "DIVISION OF GENERAL PEDIATRICS",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044319",
"telephone_number": "215-590-1220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVERETT",
"first_name": "MARIAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-09",
"last_updated": "2025-05-26",
"certification_date": "2025-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MT233388",
"primary": true
}
],
"identifiers": [],
"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 May 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.