NPIMap

Organization Active NPI

Integrated Medical Group, P.C.

  • Allergy Physician
  • Wyomissing, PA
National Provider Identifier
1366887887
Registry record updated May 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
Legal business name
INTEGRATED MEDICAL GROUP, P.C.
Practice address
2210 Ridgewood Rd
Suite 100
Wyomissing, PA 19610-1287
Phone
(610) 372-0502
Fax
(610) 372-9554
NPI assigned
May 10, 2013
Organization subpart
Yes
Parent organization
INTEGRATED MEDICAL GROUP, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 10, 2013

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

Authorized official

Name
Craig Hunt
Title
Chief Operating Officer
Phone
(570) 622-5455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207KA0200X Primary

Addresses

Primary practice location

2210 Ridgewood Rd
Suite 100
Wyomissing, PA 19610-1287

Mailing address

48 Tunnel Rd
Suite 203
Pottsville, PA 17901-3875
Phone (570) 622-5455

Other names 1

  • IMGPC Allergy Other name

National Provider Directory

National Provider Directory
Tax ID family
Integrated Medical Grou9 organizations share this tax ID, including this one
Part of
Integrated Medical Grou

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2210 Ridgewood Rd
Ste 100
Wyomissing, PA 19610
Phone (610) 372-0502

NPI Registry JSON

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

{
    "created_epoch": "1368144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368144000000",
    "number": "1366887887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 TUNNEL RD",
            "address_2": "SUITE 203",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013875",
            "telephone_number": "570-622-5455",
            "fax_number": "570-622-5493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 RIDGEWOOD RD",
            "address_2": "SUITE 100",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101287",
            "telephone_number": "610-372-0502",
            "fax_number": "610-372-9554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED MEDICAL GROUP, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTEGRATED MEDICAL GROUP, P.C.",
        "enumeration_date": "2013-05-10",
        "last_updated": "2013-05-10",
        "status": "A",
        "authorized_official_last_name": "HUNT",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "570-622-5455"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMGPC Allergy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wyomissing, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2013; 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.