South Phila PT Assoc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SOUTH PHILA PT ASSOC

Practice address

1809 W Oregon Ave
3Rd Floor
Phila, PA 19145-3710

Phone

(215) 467-1800

Fax

(215) 467-8120

NPI assigned

Jul 26, 2005

Organization subpart

No

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

Authorized official

Name

Vincent P Esposito, PT

Title

Vice-President

Phone

(215) 467-1800

Specialties & licenses 1

Addresses

Other names 1

• Pennsport West Doing business as

Locations

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245230754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 W OREGON AVE",
            "address_2": "3RD FLOOR",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191453710",
            "telephone_number": "215-467-1800",
            "fax_number": "215-467-8120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 W OREGON AVE",
            "address_2": "3RD FLOOR",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191453710",
            "telephone_number": "215-467-1800",
            "fax_number": "215-467-8120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH PHILA PT ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ESPOSITO",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "215-467-1800",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pennsport West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.