NPIMap

Organization Active NPI

Advanced Vascular and Wound Associates Inc

  • Internal Medicine Physician
  • Darby, PA
National Provider Identifier
1205376381
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ADVANCED VASCULAR AND WOUND ASSOCIATES INC
Practice address
1503 Lansdowne Ave
Suite 3006
Darby, PA 19023-1330
Phone
(610) 237-2584
NPI assigned
Mar 8, 2017
Last updated
Mar 8, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

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

Authorized official

Name
Jordan MountNPI 1750613980
Title
Nurse Practicioner
Phone
(856) 845-5344

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

1503 Lansdowne Ave
Suite 3006
Darby, PA 19023-1330

Mailing address

2009 Stone Ridge LN
Villanova, PA 19085-1723

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1488931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488931200000",
    "number": "1205376381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2009 STONE RIDGE LN",
            "city": "VILLANOVA",
            "state": "PA",
            "postal_code": "190851723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 LANSDOWNE AVE",
            "address_2": "SUITE 3006",
            "city": "DARBY",
            "state": "PA",
            "postal_code": "190231330",
            "telephone_number": "610-237-2584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED VASCULAR AND WOUND ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-08",
        "last_updated": "2017-03-08",
        "status": "A",
        "authorized_official_last_name": "MOUNT",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "NURSE PRACTICIONER",
        "authorized_official_telephone_number": "856-845-5344"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Darby, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; 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.