NPIMap

Organization Active NPI

Philadelphia College of Osteopathic Medicine

  • Clinical Psychologist
  • Philadelphia, PA
National Provider Identifier
1316230220
Registry record updated Jan 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS016978 Issued in PA
Legal business name
PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Practice address
4190 City Ave
Philadelphia, PA 19131-1633
Phone
(215) 871-6910
Fax
(251) 871-6905
NPI assigned
May 25, 2011
Last updated
Jan 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2012

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

Authorized official

Name
Kenneth Veit, DONPI 1104827286
Title
SVP of Academic Affairs and Dean
Phone
(215) 871-6770

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS016978 PA Primary

Addresses

Primary practice location

4190 City Ave
Philadelphia, PA 19131-1633

Mailing address

4190 City Ave
Suite 777
Philadelphia, PA 19131-1633
Phone (215) 871-6910

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1306281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326153600000",
    "number": "1316230220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 CITY AVE",
            "address_2": "SUITE 777",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311633",
            "telephone_number": "215-871-6910",
            "fax_number": "215-871-6905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 CITY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311633",
            "telephone_number": "215-871-6910",
            "fax_number": "251-871-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-25",
        "last_updated": "2012-01-10",
        "status": "A",
        "authorized_official_last_name": "VEIT",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "SVP OF ACADEMIC AFFAIRS AND DEAN",
        "authorized_official_telephone_number": "215-871-6770",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS016978",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 10, 2012; 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.