Active NPI
Temple University Childrens Medical Center
- Ambulatory Surgical Clinic/Center
- Philadelphia, PA
National Provider Identifier
1265586580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- License
- 101901
- Legal business name
- TEMPLE UNIVERSITY CHILDRENS MEDICAL CENTER
- Practice address
- 3509 N Broad St
Philadelphia, PA 19140-4105 - Phone
- (215) 707-5303
- NPI assigned
- Jan 23, 2007
- Organization subpart
- Yes
- Parent organization
- TEMPLE UNIVERSITY CHILDRENS MEDICAL CENTER
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Robert Lux
- Title
- VP and Cfo
- Phone
- (215) 707-3802
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | 101901 | PA | Primary |
Addresses
Primary practice location
3509 N Broad St
Philadelphia, PA 19140-4105
Mailing address
3509 N Broad St
Philadelphia, PA 19140-4105
Other identifiers 15
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1058480 | Other | NJ | HORIZON NJ |
| 1058481 | Other | PA | KEYSTONE MERCY OUTPT |
| 393306 | Other | UNITED HEALTHCARE | |
| 1004908 | Other | AETNA USHC | |
| 1007287550001 | Medicaid | PA | |
| 11 | Other | PA | ELDERHEALTH |
| 19236 | Other | PA | 19236 |
| 393306 | Other | HEALTH AMERICA | |
| 393306 | Other | CIGNA | |
| 393306 | Other | DEVON | |
| P039817 | Other | CHAMPUS TRICARE | |
| 1700 | Other | PA | IBC KHPE |
| 1058482 | Other | PA | KEYSTONE MERCY SPU |
| 1058480 | Other | PA | KEYSTONE MERCY - INPT |
| 393306 | Other | PRIVATE HEALTHCARE |
National Provider Directory
National Provider Directory- Part of
- Temple University Childrens Medical Center
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1184544000000",
"number": "1265586580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3509 N BROAD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191404105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3509 N BROAD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191404105",
"telephone_number": "215-707-5303"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TEMPLE UNIVERSITY CHILDRENS MEDICAL CENTER",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "TEMPLE UNIVERSITY CHILDRENS MEDICAL CENTER",
"enumeration_date": "2007-01-23",
"last_updated": "2007-07-16",
"status": "A",
"authorized_official_last_name": "LUX",
"authorized_official_first_name": "ROBERT",
"authorized_official_title_or_position": "VP AND CFO",
"authorized_official_telephone_number": "215-707-3802",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": "PA",
"license": "101901",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HORIZON NJ",
"identifier": "1058480",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE MERCY OUTPT",
"identifier": "1058481",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "393306",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA USHC",
"identifier": "1004908",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1007287550001",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ELDERHEALTH",
"identifier": "11",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "19236",
"identifier": "19236",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH AMERICA",
"identifier": "393306",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "393306",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEVON",
"identifier": "393306",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS TRICARE",
"identifier": "P039817",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IBC KHPE",
"identifier": "1700",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE MERCY SPU",
"identifier": "1058482",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE MERCY - INPT",
"identifier": "1058480",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIVATE HEALTHCARE",
"identifier": "393306",
"state": null
}
],
"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 Jul 16, 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.