Village Shires Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS008256L Issued in PA

Legal business name

VILLAGE SHIRES FAMILY MEDICINE

Practice address

1496 Buck Rd Ste A6
Holland, PA 18966-2626

Phone

(215) 497-1001

NPI assigned

May 22, 2007

Last updated

Oct 22, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Scott Cohen, MD

Title

Owner

Phone

(215) 497-1001

Specialties & licenses 1

Addresses

Other identifiers 7

Locations

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256169600000",
    "number": "1134339161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1496 BUCK RD STE A6",
            "city": "HOLLAND",
            "state": "PA",
            "postal_code": "189662626",
            "telephone_number": "215-497-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1496 BUCK RD STE A6",
            "city": "HOLLAND",
            "state": "PA",
            "postal_code": "189662626",
            "telephone_number": "215-497-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE SHIRES FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2009-10-22",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-497-1001",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS008256L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL CHOICE",
            "identifier": "2637013000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON",
            "identifier": "1795896",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1590387",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE",
            "identifier": "2637013001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2015082",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "3000425",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "590387",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Twining Village SNF Operating Company LLC (Holland Center for Rehabilitation and Nursing)
• Renee Julia Updegrave, CRNP
• Annie Varughese, PHARMD
• Jessica Vaysman, PT, DPT
• Karyn Vercoe
• Elizabeth Ann Vogt, OTR/L
• Edmund John Ward III
• Jamie Whiting
• Erica Louise Wiler, M.S. CCC-SLP
• Within the Fragments LLC

• Family Medicine Physician in Holland, PA
• Providers in Holland, PA by specialty
• Family Medicine Physician in Pennsylvania

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

Verify at the official NPI Registry.