NPIMap

Organization Active NPI

Fornance Physician Services, Inc.

Doing business as Trappe Pediatric Care

  • Pediatrics Physician
  • Collegeville, PA
National Provider Identifier
1235173238
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
FORNANCE PHYSICIAN SERVICES, INC.
Doing business as
Trappe Pediatric Care
Practice address
17 Iron Bridge Dr Ste 100
Collegeville, PA 19426-2042
Phone
(484) 622-6340
Fax
(484) 622-6357
NPI assigned
Jun 16, 2006
Last updated
Apr 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Authorized official

Name
Vera Burnett-Robins
Title
Director Physician Billing
Phone
(484) 622-7391

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

17 Iron Bridge Dr Ste 100
Collegeville, PA 19426-2042

Mailing address

PO Box 789967
Philadelphia, PA 19178-9967
Phone (484) 622-7395

Other identifiers 9

IdentifierTypeStateIssuer
7730228OtherPAAETNA PPO
3062149OtherPACIGNA HMO/PPO
0898365001OtherPAAMERIHEALTH/INTERCOUNTY
30000345OtherPAKEYSTONE MERCY
958315OtherPAHIGHMARK BLUE SHIELD
2542436OtherPAAETNA HMO
0898365001OtherPAIBC - PC/KHPE
2124451OtherPAALLIANCE/OPT CHC (MAMSI)
35156OtherPAHEALTH PARTNERS SITE #

Other names 1

  • Trappe Pediatric Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040216000037 PA Part B Supplier - Clinic/Group Practice 8527962661 Receives reassigned benefits from 215 practitioners
36 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: King of Prussia, PA; Lansdale, PA; Norristown, PA; North Wales, PA; Plymouth Meeting, PA; East Norriton, PA; Audubon, PA; Blue Bell, PA…

Other NPIs on the same Medicare enrollment 36

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 36

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D1044077Trappe Pediatric Care17 Iron Bridge Drive, Collegeville, PA 19426Certificate of waiverAug 9, 2027

National Provider Directory

National Provider Directory
Tax ID family
Fornance Physician Services Inc28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

Locations

17 Iron Bridge Dr
#100
Collegeville, PA 19426
Phone (484) 622-6340

1 Penn Blvd
Fl 2
Philadelphia, PA 19144

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617753600000",
    "number": "1235173238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 789967",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191789967",
            "telephone_number": "484-622-7395",
            "fax_number": "484-622-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 IRON BRIDGE DR STE 100",
            "city": "COLLEGEVILLE",
            "state": "PA",
            "postal_code": "194262042",
            "telephone_number": "484-622-6340",
            "fax_number": "484-622-6357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORNANCE PHYSICIAN SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A",
        "authorized_official_last_name": "BURNETT-ROBINS",
        "authorized_official_first_name": "VERA",
        "authorized_official_title_or_position": "DIRECTOR PHYSICIAN BILLING",
        "authorized_official_telephone_number": "484-622-7391"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7730228",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HMO/PPO",
            "identifier": "3062149",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH/INTERCOUNTY",
            "identifier": "0898365001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "30000345",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "958315",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2542436",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC - PC/KHPE",
            "identifier": "0898365001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLIANCE/OPT CHC (MAMSI)",
            "identifier": "2124451",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS SITE #",
            "identifier": "35156",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trappe Pediatric Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Trappe Pediatric Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Collegeville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.