Joan Mureen Addley, DO

Primary specialty

Adolescent Medicine (Family Medicine) PhysicianTaxonomy code 207QA0000X

License

OS010055L Issued in PA

Practice address

8125 Stenton Ave
Philadelphia, PA 19150-3530

Phone

(215) 248-7560

Fax

(215) 248-7564

NPI assigned

Jul 21, 2005

Last updated

May 17, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Philadelphia College of Osteopathic Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tanner Medical Group IncGroup PAC ID 2769536143, 120 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tanner Home Health Services Home health agency, Carrollton, GA, CCN 117319
• Tanner Medical Center Villa Rica Hospital, Villa Rica, GA, CCN 110015
• Tanner Medical Center - Carrollton Hospital, Carrollton, GA, CCN 110011
• Wellstar Douglas Medical Center Hospital, Douglasville, GA, CCN 110184

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jaddley2015965@direct.trinity-health.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tanner Medical Group Inc

  • Cardiovascular Disease Physician
  • Carrollton, GA
  • NPI 1396979787
  Medicare reassignment Care Compare group NPD
• Nazareth Physician Services, Inc

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1215452982
  NPD (past)
• Cignet Health Uplift Medical

  • Multi-Specialty Clinic/Center
  • Temple Hills, MD
  • NPI 1053475749
  NPD (past)
• TMC Children's Healthcare of West Georgia

  • Medical Specialty Clinic/Center
  • Carrollton, GA
  • NPI 1518972348
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Douglas Hospital, Inc.

  dba Wellstar Douglas Hospital

  • General Acute Care Hospital
  • Douglasville, GA
  • NPI 1649247974
  Care Compare affiliation
• Tanner Medical Center, Inc

  dba Tanner Health System

  • General Acute Care Hospital
  • Carrollton, GA
  • NPI 1801883780
  Care Compare affiliation
• TMC Home Health Inc

  • Home Health Agency
  • Carrollton, GA
  • NPI 1457376386
  Care Compare affiliation
• TMC/Villa Rica Hospital, Inc

  dba Tanner Health System

  • General Acute Care Hospital
  • Villa Rica, GA
  • NPI 1851388748
  Care Compare affiliation

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1275532160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 UNIVERSITY DR STE 106",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8125 STENTON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191503530",
            "telephone_number": "215-248-7560",
            "fax_number": "215-248-7564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDLEY",
        "first_name": "JOAN",
        "middle_name": "MUREEN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-21",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "PA",
            "license": "OS010055L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101305637",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "joan.addley.1@16196.direct.athenahealth.com",
            "affiliation": "Y",
            "endpointDescription": "Nazareth Physician Services Direct Email Address",
            "affiliationName": "Trinity Health Mid-Atlantic Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1407 Rhawn St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "19111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eileen B Addis, LCSW
• Victoria Marie Addis, M.D.
• Aisha Ayanna Addison
• Kevin Addison, ATC
• David Jerry Addley, D.O.
• Addus Health Care Inc (Addus HomeCare)
• Editus Addy
• Ajoke Olivia Adebayo
• Oluwakemi Adedokun
• Rasidat Adeduntan, MD

• Adolescent Medicine (Family Medicine) Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Adolescent Medicine (Family Medicine) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.