Oline Tree Medical Practice

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

OLINE TREE MEDICAL PRACTICE

Practice address

802 Burmont Road
Drexel Hill, PA 19026-4413

Phone

(215) 805-2647

Fax

(215) 245-4827

NPI assigned

Oct 24, 2019

Organization subpart

No

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

Authorized official

Name

Susan Baldwin

Title

Credentialing Manager

Phone

(215) 805-2647

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1571875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571875200000",
    "number": "1316580178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 WINDERMERE AVE",
            "city": "LANSDOWNE",
            "state": "PA",
            "postal_code": "190501154",
            "telephone_number": "215-805-2647",
            "fax_number": "215-245-4827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 BURMONT ROAD",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190264413",
            "telephone_number": "215-805-2647",
            "fax_number": "215-245-4827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLINE TREE MEDICAL PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-24",
        "last_updated": "2019-10-24",
        "status": "A",
        "authorized_official_last_name": "BALDWIN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "CREDENTIALING  MANAGER",
        "authorized_official_telephone_number": "215-805-2647"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles O'Donnell Jr., MSN, CRNP, PMHNP-BC
• Megan Smith O'Sullivan, MS, OTR/L
• Shannon O'Sullivan, LPC
• Temitope Ogungbemi, LBS
• Bennett Okyere
• Omo Passionate Home Healthcare, LLC
• Oriental Acu Herb LLC
• James W Ortmeyer, M.D.
• Dominic Leonard Oteri, M.D.
• Anita Ott, DO

• Family Medicine Physician in Drexel Hill, PA
• Providers in Drexel Hill, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; 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.