St. Luke'S Physician Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ST. LUKE'S PHYSICIAN GROUP, INC.

Practice address

108 W Catawissa St
Nesquehoning, PA 18240-1511

Phone

(570) 669-9990

Fax

(570) 669-9995

NPI assigned

Jan 11, 2007

Organization subpart

No

Name

Dean W Evans

Title

President

Phone

(610) 954-4991

Medicare fee-for-service enrollment

Enrolled in PA

• NESQUEHONING FAMILY PRACTICE Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 16, 2010.

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271376000000",
    "number": "1376693515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 E BROAD ST",
            "address_2": "2ND FLR",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180186332",
            "telephone_number": "610-954-6048",
            "fax_number": "610-954-3189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 W CATAWISSA ST",
            "city": "NESQUEHONING",
            "state": "PA",
            "postal_code": "182401511",
            "telephone_number": "570-669-9990",
            "fax_number": "570-669-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S PHYSICIAN GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2010-04-16",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-954-4991"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NESQUEHONING FAMILY PRACTICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kathryn Olivia Schlotter
• Rachel Seitzinger, CRNP
• Anuradha Silvonek, M.D.
• St. Luke'S Physician Group, Inc
• St. Luke'S Physician Group, Inc
• The Carbon Schuylkill Community Hospital Inc
• The Carbon-Schuylkill Community Hospital, Inc.
• Devon Warntz
• Mimi Erin Wiley, PA-C

• All providers in Nesquehoning, PA
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.