Individual provider Active NPI

Eric M Kephart, D.O.

  • Family Medicine Physician
  • Fairless Hills, PA
National Provider Identifier
1104913680
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS014338 Issued in PA
Practice address
100 Lincoln Hwy
Fairless Hills, PA 19030-1008
Phone
(267) 587-0775
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X OS014338 PA
Family Medicine Physician 207Q00000X OS014338 PA Primary
Family Medicine Physician 207Q00000X OT011732 PA

Addresses

Primary practice location

100 Lincoln Hwy
Fairless Hills, PA 19030-1008

Mailing address

5000 Cox Rd
Glen Allen, VA 23060-9263
Phone (804) 968-5700

Other practice location 1

3000 Fairway Dr
Altoona, PA 16602-4472
Phone (814) 942-1166

Other identifiers 1

IdentifierTypeStateIssuer
1022699560002MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address PAExchange@patientfirstclinics.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090715000568 PA Practitioner - Sports MedicinePractitioner - Family PracticePractitioner - Emergency Medicine 5799837167 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
Philadelphia College of Osteopathic Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

403 Hyde Park
Doylestown, PA 18902-6619
Phone (267) 406-4083

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS014338PAMDFamily Medicine Physician
OT011732PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kephartsportsmedicine LLC Sports Medicine CurrentSince Mar 8, 2022 Accepting new patients
Patient First Pennsylvania Medical Group PLLC Family Medicine CurrentSince Apr 6, 2020 Accepting new patients
Patient First Pennsylvania Medical Group PLLC Family Medicine CurrentSince Apr 6, 2020 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

403 Hyde Park
Doylestown, PA 18902
Phone (267) 406-4083

100 Lincoln Hwy
Fairless Hills, PA 19030
Phone (267) 587-0775

5125 Jonestown Rd
Ste 105
Harrisburg, PA 17112
Phone (717) 943-1566

713 Bethlehem Pike
Montgomeryvle, PA 18936
Phone (267) 695-3944

5000 Cox Rd
Glen Allen, VA 23060
Phone (804) 822-4355

Interoperability endpoints

  • Direct secure messaging: eric.kephart.1@26170.direct.athenahealth.com
  • Direct secure messaging: paexchange@patientfirstclinics.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1104913680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609263",
            "telephone_number": "804-968-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 LINCOLN HWY",
            "city": "FAIRLESS HILLS",
            "state": "PA",
            "postal_code": "190301008",
            "telephone_number": "267-587-0775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 Fairway Dr",
            "address_purpose": "LOCATION",
            "city": "Altoona",
            "state": "PA",
            "postal_code": "166024472",
            "country_code": "US",
            "telephone_number": "814-942-1166",
            "fax_number": "814-942-6222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEPHART",
        "first_name": "ERIC",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "PA",
            "license": "OS014338",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS014338",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OT011732",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022699560002",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "PAExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "100 Lincoln Hwy",
            "city": "Fairless Hills",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190301008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairless Hills, PA

Sources for this page

Verify at the official NPI Registry.