Individual provider Active NPI

Tamar V Jefferis

  • Internal Medicine Physician
  • Wallingford, PA
National Provider Identifier
1265853709
Registry record updated Dec 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD020098E Issued in PA
Practice address
19 N. Providence Road
Box 267
Wallingford, PA 19086
Phone
(610) 909-5445
NPI assigned
Dec 31, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD020098E PA Primary

Addresses

Primary practice location

19 N. Providence Road
Box 267
Wallingford, PA 19086

Mailing address

19 N. Providence Road
Box 267
Wallingford, PA 19086

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MD020098EPAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1388448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388448000000",
    "number": "1265853709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 N. PROVIDENCE ROAD",
            "address_2": "BOX 267",
            "city": "WALLINGFORD",
            "state": "PA",
            "postal_code": "19086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 N. PROVIDENCE ROAD",
            "address_2": "BOX 267",
            "city": "WALLINGFORD",
            "state": "PA",
            "postal_code": "19086",
            "telephone_number": "610-909-5445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERIS",
        "first_name": "TAMAR",
        "middle_name": "V",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-31",
        "last_updated": "2013-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD020098E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2013; 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.