Eastern PA Nephrology Assoc PC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

22191501 Issued in PA

Legal business name

EASTERN PA NEPHROLOGY ASSOC PC

Practice address

2014 City Line Rd
Suite 101
Bethlehem, PA 18017-2159

Phone

(610) 264-5199

Fax

(610) 264-5198

NPI assigned

Mar 15, 2010

Organization subpart

No

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

Authorized official

Name

Douglas Johnson, MD

Title

Owner

Phone

(610) 432-4529

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1268611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273622400000",
    "number": "1174847545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2014 CITY LINE RD",
            "address_2": "SUITE 101",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180172159",
            "telephone_number": "610-264-5199",
            "fax_number": "610-264-5198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 CITY LINE RD",
            "address_2": "SUITE 101",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180172159",
            "telephone_number": "610-264-5199",
            "fax_number": "610-264-5198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN PA NEPHROLOGY ASSOC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-15",
        "last_updated": "2010-05-12",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-432-4529",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "PA",
            "license": "22191501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryellen Katherine Dye, RN, PHD, CRNP
• John Andrew Dziewit, MD
• Sedina Dzodzomenyo
• Stephanie Earle
• East Penn Eye Associates, Inc.
• Easton Eye ,LLC
• Easton Orthopaedic Group
• David Ebbott
• Mary Eberhardt, MD
• Shawna Leigh Eberts, LPC

• Ambulatory Surgical Clinic/Center in Bethlehem, PA
• Providers in Bethlehem, PA by specialty
• Ambulatory Surgical Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2010; 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.