NPIMap

Organization Active NPI

Jefferson University Physicians

  • Internal Medicine Physician
  • Havertown, PA
National Provider Identifier
1093989220
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
JEFFERSON UNIVERSITY PHYSICIANS
Practice address
525 W Chester Pike Ste 102B
Havertown, PA 19083-4539
Phone
(610) 853-9328
NPI assigned
Apr 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Authorized official

Name
Dawn Padgett
Title
Credentialing Manager
Phone
(215) 955-1175

Specialties & licenses 1

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

Addresses

Primary practice location

525 W Chester Pike Ste 102B
Havertown, PA 19083-4539

Mailing address

PO Box 828937
Philadelphia, PA 19182-8937
Phone (215) 503-1240

Other identifiers 3

IdentifierTypeStateIssuer
3000370OtherPAKEYSTONE MERCY
595787OtherPAAETNA
0307681005OtherPAINDEPENDENCE BLUE CROSS

Other names 1

  • Internal Medicine- Dr Park Other name

National Provider Directory

National Provider Directory
Tax ID family
David Kleinman63 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

Locations

525 W Chester Pike
Ste 102B
Havertown, PA 19083
Phone (610) 853-9328

NPI Registry JSON

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

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718236800000",
    "number": "1093989220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 828937",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191828937",
            "telephone_number": "215-503-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 W CHESTER PIKE STE 102B",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190834539",
            "telephone_number": "610-853-9328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON UNIVERSITY PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-18",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A",
        "authorized_official_last_name": "PADGETT",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "215-955-1175"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "3000370",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "595787",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "0307681005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Internal Medicine- Dr Park",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Internal Medicine- Dr Park",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Havertown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; 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.