East Norriton Physicians Services

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

EAST NORRITON PHYSICIANS SERVICES

Practice address

700 Dekalb St
Bridgeport, PA 19405-1149

Phone

(610) 277-6200

Fax

(610) 277-3437

NPI assigned

Sep 8, 2005

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) 567-6967

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• Bridgeport Family Practice Doing business as

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1124012828",
    "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": "700 DEKALB ST",
            "city": "BRIDGEPORT",
            "state": "PA",
            "postal_code": "194051149",
            "telephone_number": "610-277-6200",
            "fax_number": "610-277-3437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST NORRITON PHYSICIANS SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-08",
        "last_updated": "2008-03-11",
        "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": "KHPE",
            "identifier": "0899194001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KMHP",
            "identifier": "0899194001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AUSHC OFFICE NUMBER",
            "identifier": "298",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AUSHC PPO",
            "identifier": "5176213",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AUSHC HMO",
            "identifier": "0018011",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007594660059",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "852929",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridgeport Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Melissa M Dollarton, COTA/L
• Lenore Farmer, MD
• Kerri Gavin
• George R Homa, DO
• Honest Care Group LLC
• Joshua Hong, LMT

• All providers in Bridgeport, PA
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.