Active NPI
University of Penn - Anesthesia
- Anesthesiology Physician
- Philadelphia, PA
National Provider Identifier
1386674463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- Legal business name
- UNIVERSITY OF PENN - ANESTHESIA
- Practice address
- 3400 Spruce St
4 Dulles Building
Philadelphia, PA 19104-4206 - Phone
- (215) 349-8310
- NPI assigned
- Jul 4, 2006
- Last updated
- Oct 22, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Elizabeth Johnston
- Title
- Executive Director
- Phone
- (215) 662-7583
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | NU | Primary | |
| Critical Care Medicine (Anesthesiology) Physician | 207LC0200X | NU | ||
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | NU |
Addresses
Primary practice location
3400 Spruce St
4 Dulles Building
Philadelphia, PA 19104-4206
Mailing address
3624 Market St
Suite 560W
Philadelphia, PA 19104-2614
Phone (215) 662-2286
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 066244 | Other | PA | BLUE SHIELD |
| 0006733040011 | Medicaid | PA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1350864000000",
"number": "1386674463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3624 MARKET ST",
"address_2": "SUITE 560W",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191042614",
"telephone_number": "215-662-2286",
"fax_number": "215-615-0500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 SPRUCE ST",
"address_2": "4 DULLES BUILDING",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044206",
"telephone_number": "215-349-8310"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UNIVERSITY OF PENN - ANESTHESIA",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-04",
"last_updated": "2012-10-22",
"status": "A",
"authorized_official_last_name": "JOHNSTON",
"authorized_official_first_name": "ELIZABETH",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "215-662-7583"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "207LC0200X",
"taxonomy_group": "",
"desc": "Anesthesiology, Critical Care Medicine",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "066244",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0006733040011",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
- Universal Vare Charter School
- University City Dental Center (University City Dental)
- University City Operator LLC (University City Rehabilitation and Healthcare Center)
- University Medevac, LLC
- University Neurosurgical, PC
- University of Penn - Dermatology
- University of Penn - Dermatology
- University of Penn - Medical Group
- University of Penn - Medical Group
- University of Penn - Medical Group
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.