NPIMap

Organization Active NPI

Easter Seals of Southeastern Pennsylvania

  • Speech-Language Pathologist
  • Philadelphia, PA
National Provider Identifier
1285761031
Registry record updated Dec 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
EASTER SEALS OF SOUTHEASTERN PENNSYLVANIA
Practice address
3975 Conshohocken Ave
Philadelphia, PA 19131-5426
Phone
(215) 879-1000
Fax
(215) 879-8424
NPI assigned
Feb 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2018

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

Authorized official

Name
Ms. Ivy C Lewis
Title
Director of Finance Cfo
Phone
(215) 879-3542

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Assistive Technology Practitioner Rehabilitation CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 225CA2400X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

3975 Conshohocken Ave
Philadelphia, PA 19131-5426

Mailing address

3975 Conshohocken Ave
Philadelphia, PA 19131-5426
Phone (215) 879-1000

Other identifiers 1

IdentifierTypeStateIssuer
1000005500019MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Easter Seals of Southeastern Pennsylvania5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544659200000",
    "number": "1285761031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3975 CONSHOHOCKEN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191315426",
            "telephone_number": "215-879-1000",
            "fax_number": "215-879-8424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 CONSHOHOCKEN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191315426",
            "telephone_number": "215-879-1000",
            "fax_number": "215-879-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTER SEALS OF SOUTHEASTERN PENNSYLVANIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2018-12-13",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "IVY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE CFO",
        "authorized_official_telephone_number": "215-879-3542",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225CA2400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Rehabilitation Counselor, Assistive Technology Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000005500019",
            "state": "PA"
        }
    ],
    "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 Dec 13, 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.