Organization Active NPI

East Norriton Physicians Services

  • Family Medicine Physician
  • Blue Bell, PA
National Provider Identifier
1124011929
Registry record updated May 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
EAST NORRITON PHYSICIANS SERVICES
Practice address
725 Skippack Pike
Parec Plaza 2ND Floor
Blue Bell, PA 19422-1741
Phone
(215) 542-1300
Fax
(215) 643-3123
NPI assigned
Aug 26, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2008

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: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

725 Skippack Pike
Parec Plaza 2ND Floor
Blue Bell, PA 19422-1741

Mailing address

1 W Elm St
Suite 100
Conshohocken, PA 19428-2007
Phone (610) 567-6967

Other identifiers 8

IdentifierTypeStateIssuer
30029546OtherPAKMHP
427OtherPAAETNA OFFICE NUMBER
000040925OtherPAHIGHMARK BLUE SHIELD
4422178OtherPAAUSHC PPO
1007594660064MedicaidPA
0019286OtherPAAUSHC HMO
0707702001OtherPAKHPE
202608200OtherPAOWCP

Other names 1

  • Blue Bell Family Medicine Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210204800000",
    "number": "1124011929",
    "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": "194282007",
            "telephone_number": "610-567-6967",
            "fax_number": "610-567-6955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 SKIPPACK PIKE",
            "address_2": "PAREC PLAZA 2ND FLOOR",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194221741",
            "telephone_number": "215-542-1300",
            "fax_number": "215-643-3123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST NORRITON PHYSICIANS SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-26",
        "last_updated": "2008-05-08",
        "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KMHP",
            "identifier": "30029546",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA OFFICE NUMBER",
            "identifier": "427",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "000040925",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AUSHC PPO",
            "identifier": "4422178",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007594660064",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AUSHC HMO",
            "identifier": "0019286",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KHPE",
            "identifier": "0707702001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "202608200",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Bell Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blue Bell, PA

Sources for this page

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