Organization Active NPI

Aggie MD Wholistic Doctor LLC

  • Family Medicine Physician
  • Chesterbrook, PA
National Provider Identifier
1194121459
Registry record updated Nov 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD426246 Issued in PA
Legal business name
AGGIE MD WHOLISTIC DOCTOR LLC
Practice address
50 Flintlock LN
Chesterbrook, PA 19087-5634
Phone
(610) 506-4874
Fax
(215) 881-9700
NPI assigned
Nov 14, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2014

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

Authorized official

Name
Dr. Agnes Marie Hewitt, MD
Title
MD
Phone
(610) 506-4874

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X MD426246 PA Primary

Addresses

Primary practice location

50 Flintlock LN
Chesterbrook, PA 19087-5634

Mailing address

50 Flintlock LN
Chesterbrook, PA 19087-5634
Phone (610) 506-4874

National Provider Directory

National Provider Directory

Locations

789 E Lancaster Ave
Ste 23
Villanova, PA 19085
Phone (610) 506-4874

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1415923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415923200000",
    "number": "1194121459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 FLINTLOCK LN",
            "city": "CHESTERBROOK",
            "state": "PA",
            "postal_code": "190875634",
            "telephone_number": "610-506-4874",
            "fax_number": "215-881-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 FLINTLOCK LN",
            "city": "CHESTERBROOK",
            "state": "PA",
            "postal_code": "190875634",
            "telephone_number": "610-506-4874",
            "fax_number": "215-881-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGGIE MD WHOLISTIC DOCTOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-14",
        "last_updated": "2014-11-14",
        "status": "A",
        "authorized_official_last_name": "HEWITT",
        "authorized_official_first_name": "AGNES",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "610-506-4874",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD426246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterbrook, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2014; 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.