Integrated Medical Group, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

INTEGRATED MEDICAL GROUP, P.C.

Practice address

1555 Medical Dr
Pottstown, PA 19464-3224

Phone

(610) 396-5163

Fax

(570) 624-4778

NPI assigned

Nov 2, 2020

Last updated

Nov 2, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kimberly Walsh

Title

Director of Operations

Phone

(570) 622-5455

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1604275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604275200000",
    "number": "1245831882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 TUNNEL RD",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013869",
            "telephone_number": "570-622-5455",
            "fax_number": "570-622-5493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 MEDICAL DR",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194643224",
            "telephone_number": "610-396-5163",
            "fax_number": "570-624-4778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED MEDICAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-02",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A",
        "authorized_official_last_name": "WALSH",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "570-622-5455"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.