NPIMap

Organization Active NPI

Chester Family Practice

  • Family Medicine Physician
  • Chester, PA
National Provider Identifier
1356454706
Registry record updated May 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD029229E Issued in PA
Legal business name
CHESTER FAMILY PRACTICE
Practice address
521 E 9TH St
Chester, PA 19013-6136
Phone
(610) 872-0565
Fax
(610) 872-4478
NPI assigned
Aug 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2008

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

Authorized official

Name
Dr. Marylyn Ann Mudrick, MDNPI 1639132145
Title
Owner
Phone
(610) 872-0565

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X MD029229E PA Primary

Addresses

Primary practice location

521 E 9TH St
Chester, PA 19013-6136

Mailing address

521 E 9TH St
Chester, PA 19013-6136
Phone (610) 872-0565

Other identifiers 2

IdentifierTypeStateIssuer
0554265001MedicaidPA
5023294OtherPABLUE SHIELD

National Provider Directory

National Provider Directory

Locations

521 E 9th St
Chester, PA 19013
Phone (610) 872-0565

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209686400000",
    "number": "1356454706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 E 9TH ST",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "190136136",
            "telephone_number": "610-872-0565",
            "fax_number": "610-872-4478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 E 9TH ST",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "190136136",
            "telephone_number": "610-872-0565",
            "fax_number": "610-872-4478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESTER FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2008-05-02",
        "status": "A",
        "authorized_official_last_name": "MUDRICK",
        "authorized_official_first_name": "MARYLYN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-872-0565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD029229E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0554265001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "5023294",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, PA

Sources for this page

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