Providence Ear Nose & Throat Associates Inc

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

PROVIDENCE EAR NOSE & THROAT ASSOCIATES INC

Practice address

Riddle Mem. Hosp.- Outpt. Pav.
1098 W. Baltimore PK. Ste 3406
Media, PA 19063-5139

Phone

(610) 874-5366

Fax

(610) 874-8448

NPI assigned

Mar 27, 2019

Organization subpart

No

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

Authorized official

Name

John M Feehery, MD

Title

Authorized Official

Phone

(610) 874-5366

Specialties & licenses 1

Addresses

Electronic endpoints 1

Tax ID family

Providence Ear Nose Throat Associates Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Providence Ear Nose & Throat Associates Inc

  • Otolaryngology Physician
  • Glen Mills, PA
  • NPI 1619437654
  NPD tax ID

Interoperability endpoints

• Direct secure messaging: jfeehery@providenceent.medentdirect.com

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618358400000",
    "number": "1134680747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 PROVIDENCE AVE",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "190135507",
            "telephone_number": "610-874-5366",
            "fax_number": "610-874-8448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RIDDLE MEM. HOSP.- OUTPT. PAV.",
            "address_2": "1098 W. BALTIMORE PK. STE 3406",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635139",
            "telephone_number": "610-874-5366",
            "fax_number": "610-874-8448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE EAR NOSE & THROAT ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-27",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A",
        "authorized_official_last_name": "FEEHERY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "610-874-5366",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jfeehery@providenceent.medentdirect.com",
            "affiliation": "N",
            "address_1": "Riddle Mem. Hosp.- OutPt. Pav.",
            "address_2": "1098 W. Baltimore Pk. Ste 3406",
            "city": "Media",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190635139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Samantha Presock, RBT
• Joshua Christopher Proctor
• Professional Pain Managment Associates, PC
• John A Pron, DPM
• Prospect CCMC, LLC
• Providence Living LLC
• Providence Pediatric Practice LLC
• Pulmonary Care Associates LTD
• Pulmonary Critical Care & Sleep Physicians of the Main Line PC
• Pulmonary Critical Care and Sleep Associates, P.C.

• Otolaryngology Physician in Media, PA
• Providers in Media, PA by specialty
• Otolaryngology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; 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.