NPIMap

Organization Active NPI

Thomas Jefferson University

  • Specialist
  • Philadelphia, PA
National Provider Identifier
1124195854
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD053709L Issued in PA
Legal business name
THOMAS JEFFERSON UNIVERSITY
Practice address
111 S 11TH St
Suite 4240
Philadelphia, PA 19107-4824
Phone
(215) 955-8874
NPI assigned
Nov 29, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Susan Beal
Title
Director
Phone
(215) 503-1295

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X MD053709L PA Primary

Addresses

Primary practice location

111 S 11TH St
Suite 4240
Philadelphia, PA 19107-4824

Mailing address

125 S 9TH St
Suite 801
Philadelphia, PA 19107-5125
Phone (215) 955-9642

National Provider Directory

National Provider Directory
Tax ID family
Jefferson Community Onc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

111 S 11th St
Ste 4240
Philadelphia, PA 19107
Phone (215) 955-6550

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124195854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S 9TH ST",
            "address_2": "SUITE 801",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075125",
            "telephone_number": "215-955-9642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "address_2": "SUITE 4240",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-8874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS JEFFERSON UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BEAL",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "215-503-1295"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD053709L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.