Active NPI
Jeffrey William McCann
- Diagnostic Radiology Physician
- Philadelphia, PA
National Provider Identifier
1124260054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- MD436196
- Practice address
- 111 S 11TH St
Suite 3390
Philadelphia, PA 19107-4824 - Phone
- (215) 955-6226
- Fax
- (215) 923-1562
- NPI assigned
- Mar 24, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | MD436196 | PA | Primary |
Addresses
Primary practice location
111 S 11TH St
Suite 3390
Philadelphia, PA 19107-4824
Mailing address
615 Chestnut St
14TH Floor
Philadelphia, PA 19106-4404
Phone (215) 955-2141
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1022806590001 | Medicaid | PA | |
| 0190811 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242172800000",
"number": "1124260054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 CHESTNUT ST",
"address_2": "14TH FLOOR",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191064404",
"telephone_number": "215-955-2141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 S 11TH ST",
"address_2": "SUITE 3390",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191074824",
"telephone_number": "215-955-6226",
"fax_number": "215-923-1562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCANN",
"first_name": "JEFFREY",
"middle_name": "WILLIAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-03-24",
"last_updated": "2009-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "PA",
"license": "MD436196",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1022806590001",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0190811",
"state": "NJ"
}
],
"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 May 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.