NPIMap

Organization Active NPI

Jennersville Medical Associates, PC

  • Internal Medicine Physician
  • West Grove, PA
National Provider Identifier
1073748844
Registry record updated Sep 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS004477L Issued in PA
Legal business name
JENNERSVILLE MEDICAL ASSOCIATES, PC
Practice address
1011 W Baltimore Pike
Suite 301
West Grove, PA 19390-9446
Phone
(610) 869-3620
Fax
(610) 869-0358
NPI assigned
May 22, 2009
Last updated
Sep 28, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2010

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

Authorized official

Name
Dr. David M Callahan, D.O.NPI 1386660157
Title
President
Phone
(610) 869-3620

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X OS004477L PA Primary

Addresses

Primary practice location

1011 W Baltimore Pike
Suite 301
West Grove, PA 19390-9446

Mailing address

1011 W Baltimore Pike
Suite 301
West Grove, PA 19390-9446
Phone (610) 869-3620

National Provider Directory

National Provider Directory

Locations

1011 W Baltimore Pike
Ste 301
West Grove, PA 19390
Phone (610) 869-3620

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1242950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285632000000",
    "number": "1073748844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 W BALTIMORE PIKE",
            "address_2": "SUITE 301",
            "city": "WEST GROVE",
            "state": "PA",
            "postal_code": "193909446",
            "telephone_number": "610-869-3620",
            "fax_number": "610-869-0358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 W BALTIMORE PIKE",
            "address_2": "SUITE 301",
            "city": "WEST GROVE",
            "state": "PA",
            "postal_code": "193909446",
            "telephone_number": "610-869-3620",
            "fax_number": "610-869-0358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNERSVILLE MEDICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-22",
        "last_updated": "2010-09-28",
        "status": "A",
        "authorized_official_last_name": "CALLAHAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-869-3620",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS004477L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Grove, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.