NPIMap

Organization Active NPI

Mercy Management of Southeastern Pennsylvani

Doing business as MMSEPA P PCP Chestnut Office

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1265956973
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANI
Doing business as
MMSEPA P PCP Chestnut Office
Practice address
5630 Chestnut St
Philadelphia, PA 19139
Phone
(215) 748-3100
NPI assigned
Aug 3, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Authorized official

Name
Beth Hopkins
Title
Director Billing
Phone
(610) 567-5239

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X PA
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X PA Primary

Addresses

Primary practice location

5630 Chestnut St
Philadelphia, PA 19139

Mailing address

1 W Elm St
Conshohocken, PA 19428-4108
Phone (610) 567-6964

Other names 1

  • MMSEPA P PCP Chestnut Office Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530144000000",
    "number": "1265956973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W ELM ST",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194284108",
            "telephone_number": "610-567-6964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5630 CHESTNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19139",
            "telephone_number": "215-748-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANI",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-03",
        "last_updated": "2018-06-28",
        "status": "A",
        "authorized_official_last_name": "HOPKINS",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "DIRECTOR BILLING",
        "authorized_official_telephone_number": "610-567-5239"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MMSEPA P PCP Chestnut Office",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 28, 2018; 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.