NPIMap

Organization Active NPI

Nazareth Physician Services Inc

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1356377550
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NAZARETH PHYSICIAN SERVICES INC
Practice address
7044 Torresdale Ave
Philadelphia, PA 19135-1915
Phone
(215) 332-7772
Fax
(215) 332-2547
NPI assigned
Jun 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2008

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

Authorized official

Name
Mr. John J Kirby
Title
Executive Director
Phone
(215) 335-6614

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

7044 Torresdale Ave
Philadelphia, PA 19135-1915

Mailing address

1 W Elm St
Suite 100
Conshohocken, PA 19428-2007
Phone (610) 567-6967

Other identifiers 4

IdentifierTypeStateIssuer
658619OtherPAAETNA OFFICE #
101465514 0003MedicaidPA
2457876002OtherPAIBC#
NA1775677OtherPAHIGHMARK BLUE SHIELD

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207699200000",
    "number": "1356377550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W ELM ST",
            "address_2": "SUITE 100",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282007",
            "telephone_number": "610-567-6967",
            "fax_number": "610-567-6170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7044 TORRESDALE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191351915",
            "telephone_number": "215-332-7772",
            "fax_number": "215-332-2547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAZARETH PHYSICIAN SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2008-04-09",
        "status": "A",
        "authorized_official_last_name": "KIRBY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "215-335-6614",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA OFFICE #",
            "identifier": "658619",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101465514 0003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC#",
            "identifier": "2457876002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "NA1775677",
            "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 Apr 9, 2008; 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.