Active NPI
Elliot L Gevis, D.O.
- Pediatrics Physician
- Philadelphia, PA
National Provider Identifier
1356332928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- OS006045L
- Practice address
- 3380 Memphis St
Philadelphia, PA 19134-4510 - Phone
- (215) 426-5566
- Fax
- (215) 739-3904
- NPI assigned
- Nov 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | OS006045L | PA | Primary |
Addresses
Primary practice location
3380 Memphis St
Philadelphia, PA 19134-4510
Mailing address
3380 Memphis St
Philadelphia, PA 19134-4510
Phone (215) 426-5566
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS006045L | PA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356332928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3380 MEMPHIS ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191344510",
"telephone_number": "215-426-5566",
"fax_number": "215-739-3904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3380 MEMPHIS ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191344510",
"telephone_number": "215-426-5566",
"fax_number": "215-739-3904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEVIS",
"first_name": "ELLIOT",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "OS006045L",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.