East Norriton Physicians Services

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

Legal business name

EAST NORRITON PHYSICIANS SERVICES

Practice address

716 W Germantown Pike
East Norriton, PA 19403-4255

Phone

(610) 631-2159

Fax

(610) 631-7645

NPI assigned

Sep 25, 2007

Organization subpart

No

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

Authorized official

Name

Peter B Kenniff

Title

Cfo

Phone

(610) 631-2159

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• Mercy Sports Medicine Doing business as

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219363200000",
    "number": "1104013085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W ELM ST",
            "address_2": "SUITE 100",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194284108",
            "telephone_number": "610-567-6967",
            "fax_number": "610-567-6170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 W GERMANTOWN PIKE",
            "city": "EAST NORRITON",
            "state": "PA",
            "postal_code": "194034255",
            "telephone_number": "610-631-2159",
            "fax_number": "610-631-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST NORRITON PHYSICIANS SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-25",
        "last_updated": "2008-08-22",
        "status": "A",
        "authorized_official_last_name": "KENNIFF",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "610-631-2159"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KHPE",
            "identifier": "2097129000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KMHP",
            "identifier": "1026335",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AUSHC PPO",
            "identifier": "5178482",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AUSHC HMO",
            "identifier": "5399",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "DE1404878",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100759466 0038",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "202264000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Sports Medicine (Family Medicine) Physician in East Norriton, PA
• Providers in East Norriton, PA by specialty
• Sports Medicine (Family Medicine) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2008; 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.