Organization Active NPI

East Norriton Physicians Services

  • Family Medicine Physician
  • East Norriton, PA
National Provider Identifier
1104096593
Registry record updated Mar 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
EAST NORRITON PHYSICIANS SERVICES
Practice address
190 W Germantown Pike
Suite 110
East Norriton, PA 19401-1385
Phone
(610) 272-0190
Fax
(610) 272-4428
NPI assigned
Mar 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2010

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) 567-6967

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

190 W Germantown Pike
Suite 110
East Norriton, PA 19401-1385

Mailing address

1 W Elm St
Suite 100
Conshohocken, PA 19428-4108
Phone (610) 567-6967

Other identifiers 4

IdentifierTypeStateIssuer
2025321OtherPAHIGHMARK BLUE SHIELD
3424972001OtherPAIBC/KHPE
1007594660066MedicaidPA
30050608OtherPAKEYSTONE MERCY

Other names 1

  • Mercy Family Medicine of East Norriton Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268179200000",
    "number": "1104096593",
    "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": "190 W GERMANTOWN PIKE",
            "address_2": "SUITE 110",
            "city": "EAST NORRITON",
            "state": "PA",
            "postal_code": "194011385",
            "telephone_number": "610-272-0190",
            "fax_number": "610-272-4428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST NORRITON PHYSICIANS SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-03",
        "last_updated": "2010-03-10",
        "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": "610-567-6967"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "2025321",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC/KHPE",
            "identifier": "3424972001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007594660066",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "30050608",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Family Medicine of East Norriton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in East Norriton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.