NPIMap

Organization Active NPI

Integrated Medical Group, PC

  • Family Nurse Practitioner
  • Fleetwood, PA
National Provider Identifier
1184076663
Registry record updated Jul 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP016169 Issued in PA
Legal business name
INTEGRATED MEDICAL GROUP, PC
Practice address
805 N Richmond St
Fleetwood, PA 19522-1058
Phone
(610) 944-0464
NPI assigned
Jul 7, 2016
Last updated
Jul 7, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2016

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

Authorized official

Name
Barbara J McCulley
Title
Office Manager
Phone
(610) 944-0464

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X SP016169 PA Primary

Addresses

Primary practice location

805 N Richmond St
Fleetwood, PA 19522-1058

Mailing address

4 Ravens CT
Reading, PA 19606-3551

National Provider Directory

National Provider Directory
Tax ID family
Img PT9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1467849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467849600000",
    "number": "1184076663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 RAVENS CT",
            "city": "READING",
            "state": "PA",
            "postal_code": "196063551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 N RICHMOND ST",
            "city": "FLEETWOOD",
            "state": "PA",
            "postal_code": "195221058",
            "telephone_number": "610-944-0464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED MEDICAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-07",
        "last_updated": "2016-07-07",
        "status": "A",
        "authorized_official_last_name": "MCCULLEY",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "610-944-0464"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP016169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fleetwood, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2016; 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.