Mt Airy/ Germantown Medical and Rehab Associates

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

MD061558L Issued in PA

Legal business name

MT AIRY/ GERMANTOWN MEDICAL AND REHAB ASSOCIATES

Practice address

5751 N Broad St
Philadelphia, PA 19141-2307

Phone

(215) 843-0672

Fax

(215) 843-0674

NPI assigned

Jun 26, 2008

Last updated

Jun 26, 2008By 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

Mr. George Edward Fisher, M.D.NPI 1477649176

Title

Medical Doctor

Phone

(215) 843-0672

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Broad and Grange Family Practice Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• George Edward Fisher, MD

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1477649176
  NPD (past) Authorized official

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1164684601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5751 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191412307",
            "telephone_number": "215-843-0672",
            "fax_number": "215-843-0674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5751 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191412307",
            "telephone_number": "215-843-0672",
            "fax_number": "215-843-0674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT AIRY/ GERMANTOWN MEDICAL AND REHAB ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-26",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "215-843-0672",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "PA",
            "license": "MD061558L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "34699 MD061558L",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KHPE, PERSONAL CHOICE",
            "identifier": "2265537000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "30010670",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "HMO2590672",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/ BLUE SHIELD",
            "identifier": "954658",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broad and Grange Family Practice",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sarah Mrozowski
• MSG Home Care Agency LLC
• Mt Airy Family Pharmacy
• Mt Airy Family Practice
• Mt Airy Pediatrics, LLP
• Mt. Airy Anesthesiology Associates, LLC
• Mt. Airy Pediatrics, P.C.
• Jahi B Mtaalamu, DDS
• Jeanette Mtanos, LMFT
• MTC Wellness, LLC

• Primary Care Clinic/Center in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Primary Care Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.