NPIMap

Organization Active NPI

Jefferson University Radiology Associates

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1407019201
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
JEFFERSON UNIVERSITY RADIOLOGY ASSOCIATES
Practice address
850 Walnut St
Philadelphia, PA 19107-5109
Phone
(215) 503-4900
Fax
(215) 503-4920
NPI assigned
Jul 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Authorized official

Name
Amy Stout
Title
President/Ceo
Phone
(615) 261-2306

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

850 Walnut St
Philadelphia, PA 19107-5109

Mailing address

800 Crescent Centre Dr Ste 400
Franklin, TN 37067-7270
Phone (615) 261-2306

National Provider Directory

National Provider Directory
Tax ID family
Jefferson University Radiology Associates LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1407019201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CRESCENT CENTRE DR STE 400",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370677270",
            "telephone_number": "615-261-2306",
            "fax_number": "855-588-3545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 WALNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075109",
            "telephone_number": "215-503-4900",
            "fax_number": "215-503-4920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON UNIVERSITY RADIOLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-02",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A",
        "authorized_official_last_name": "STOUT",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "615-261-2306"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.