Active NPI
Univ of Penn - OB-GYN
- Maternal & Fetal Medicine Physician
- Philadelphia, PA
National Provider Identifier
1295856771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Maternal & Fetal Medicine Physician
- Legal business name
- UNIV OF PENN - OB-GYN
- Practice address
- 3400 Spruce St
2000 Courtyard Building
Philadelphia, PA 19104-4206 - Phone
- (215) 662-2982
- NPI assigned
- Apr 3, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Elizabeth Johnston
- Title
- Executive Director
- Phone
- (215) 662-7583
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Maternal & Fetal Medicine Physician | 207VM0101X | PA | Primary |
Addresses
Primary practice location
3400 Spruce St
2000 Courtyard Building
Philadelphia, PA 19104-4206
Mailing address
3624 Market St
Suite 560W
Philadelphia, PA 19104-2614
Phone (215) 662-2286
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 490662 | Other | PA | AETNA |
| 7298609 | Medicaid | NJ | |
| 1012027 | Other | PA | KEYSTONE MERCY |
| 2Y20350 | Other | PA | HEALTHNET |
| DA9430 | Other | PA | RAILROAD MEDICARE |
| 0372782000 | Other | PA | KEYSTONE |
| 273227 | Other | PA | MAMSI |
| 532383 | Other | PA | BLUE SHIELD |
| 1007448840 | Medicaid | PA | |
| 25607 | Other | PA | HEALTHPARTNERS |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1295856771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3624 MARKET ST",
"address_2": "SUITE 560W",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191042614",
"telephone_number": "215-662-2286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 SPRUCE ST",
"address_2": "2000 COURTYARD BUILDING",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044206",
"telephone_number": "215-662-2982"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UNIV OF PENN - OB-GYN",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-03",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "JOHNSTON",
"authorized_official_first_name": "ELIZABETH",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "215-662-7583"
},
"taxonomies": [
{
"code": "207VM0101X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
"state": "PA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "490662",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7298609",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE MERCY",
"identifier": "1012027",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "2Y20350",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "DA9430",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE",
"identifier": "0372782000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "273227",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "532383",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1007448840",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "25607",
"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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.