NPIMap

Organization Active NPI

Saint Vincent Medical Education and Research Institute

Doing business as Saint Vincent Sports Medicine

  • Family Medicine Physician
  • Erie, PA
National Provider Identifier
1306931134
Registry record updated Nov 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SAINT VINCENT MEDICAL EDUCATION AND RESEARCH INSTITUTE
Doing business as
Saint Vincent Sports Medicine
Practice address
4671 W Lake Rd
Erie, PA 16505-1441
Phone
(814) 835-2035
Fax
(814) 835-2806
NPI assigned
Oct 4, 2006
Last updated
Nov 2, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2010

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

Authorized official

Name
Patricia Ballman
Title
Executive Director
Phone
(814) 452-5296

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Sports Medicine (Family Medicine) Physician 207QS0010X NU

Addresses

Primary practice location

4671 W Lake Rd
Erie, PA 16505-1441

Mailing address

3530 Peach St
Suite LL1
Erie, PA 16508-2768
Phone (814) 860-5036

Other names 1

  • Saint Vincent Sports Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Medvantx Inc79 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

4671 W Lake Rd
Erie, PA 16505
Phone (814) 835-2035

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288656000000",
    "number": "1306931134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3530 PEACH ST",
            "address_2": "SUITE LL1",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165082768",
            "telephone_number": "814-860-5036",
            "fax_number": "814-860-5063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4671 W LAKE RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165051441",
            "telephone_number": "814-835-2035",
            "fax_number": "814-835-2806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT VINCENT MEDICAL EDUCATION AND RESEARCH INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2010-11-02",
        "status": "A",
        "authorized_official_last_name": "BALLMAN",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "814-452-5296"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saint Vincent Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; 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.