NPIMap

Organization Active NPI

Mo Medical Management Inc.

  • Multi-Specialty Clinic/Center
  • Kingston, PA
National Provider Identifier
1083161970
Registry record updated Sep 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
MO MEDICAL MANAGEMENT INC.
Practice address
675 Wyoming Avenue
Kingston, PA 18704-3831
Phone
(570) 288-4205
Fax
(570) 288-4889
NPI assigned
Sep 8, 2016
Last updated
Sep 8, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2016

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

Authorized official

Name
Mr. Philip James Mertz, PHD
Title
President
Phone
(570) 288-4205

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

675 Wyoming Avenue
Kingston, PA 18704-3831

Mailing address

675 Wyoming Avenue
Kingston, PA 18704-3831
Phone (570) 288-4205

National Provider Directory

National Provider Directory

Locations

675 Wyoming Ave
Kingston, PA 18704
Phone (570) 288-4205

Practitioners & affiliated clinicians

Practitioners 10

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": "1473292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473292800000",
    "number": "1083161970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 WYOMING AVENUE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187043831",
            "telephone_number": "570-288-4205",
            "fax_number": "570-288-4889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 WYOMING AVENUE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187043831",
            "telephone_number": "570-288-4205",
            "fax_number": "570-288-4889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MO MEDICAL MANAGEMENT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-08",
        "last_updated": "2016-09-08",
        "status": "A",
        "authorized_official_last_name": "MERTZ",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-288-4205",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; 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.