Star Advanced Medicine LLC

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

Legal business name

STAR ADVANCED MEDICINE LLC

Practice address

2325 Heritage Center Dr Ste 215
Furlong, PA 18925-1262

Phone

(267) 544-0664

NPI assigned

Aug 18, 2017

Organization subpart

No

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

Authorized official

Name

Bonnie McKinley, DO

Title

Ceo

Phone

(267) 544-0664

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1356867618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 HERITAGE CENTER DR STE 215",
            "city": "FURLONG",
            "state": "PA",
            "postal_code": "189251262",
            "telephone_number": "267-544-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 HERITAGE CENTER DR STE 215",
            "city": "FURLONG",
            "state": "PA",
            "postal_code": "189251262",
            "telephone_number": "267-544-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAR ADVANCED MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-18",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MCKINLEY",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "267-544-0664",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sports Medicine (Family Medicine) Physician in Furlong, PA
• Providers in Furlong, PA by specialty
• Sports Medicine (Family Medicine) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.