Internal Medicine Specialist LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS009043L Issued in PA

Legal business name

INTERNAL MEDICINE SPECIALIST LLC

Practice address

80 Second Street Pike
Suite 2
Southampton, PA 18966-3800

Phone

(215) 322-5002

Fax

(215) 322-5008

NPI assigned

Feb 8, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Samuel Paul Purpura Jr., DO

Title

Physician Owner

Phone

(215) 322-5002

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197417600000",
    "number": "1174596530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 SECOND STREET PIKE",
            "address_2": "SUITE 2",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189663800",
            "telephone_number": "215-322-5002",
            "fax_number": "215-322-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SECOND STREET PIKE",
            "address_2": "SUITE 2",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189663800",
            "telephone_number": "215-322-5002",
            "fax_number": "215-322-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE SPECIALIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-08",
        "last_updated": "2007-12-12",
        "status": "A",
        "authorized_official_last_name": "PURPURA",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "215-322-5002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS009043L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "034025TNR",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; 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.