NPIMap

Organization Active NPI

US Vascular Access Center of Philadelphia, LLC

  • Clinical Medical Laboratory
  • Philadelphia, PA
National Provider Identifier
1225212137
Registry record updated Dec 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
20461501 Issued in PA
Legal business name
US VASCULAR ACCESS CENTER OF PHILADELPHIA, LLC
Practice address
4220 Market St
Second Floor
Philadelphia, PA 19104-3007
Phone
(215) 386-4959
NPI assigned
Dec 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2007

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

Authorized official

Name
Ms. Edith Montgomery
Title
Sr.MGR. Regulatory/Reimbursement
Phone
(407) 661-5766

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 20461501 PA Primary

Addresses

Primary practice location

4220 Market St
Second Floor
Philadelphia, PA 19104-3007

Mailing address

4220 Market St
Second Floor
Philadelphia, PA 19104-3007
Phone (215) 386-4959

Other identifiers 1

IdentifierTypeStateIssuer
20461501OtherPASTATE LICENSE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198713600000",
    "number": "1225212137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 MARKET ST",
            "address_2": "SECOND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043007",
            "telephone_number": "215-386-4959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 MARKET ST",
            "address_2": "SECOND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043007",
            "telephone_number": "215-386-4959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "US VASCULAR ACCESS CENTER OF PHILADELPHIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2007-12-27",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "EDITH",
        "authorized_official_title_or_position": "SR.MGR. REGULATORY/REIMBURSEMENT",
        "authorized_official_telephone_number": "407-661-5766",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PA",
            "license": "20461501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "20461501",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.