Organization Active NPI

Family Practice of Jeffersonville, LLC

  • Family Medicine Physician
  • East Norriton, PA
National Provider Identifier
1407096910
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS006142L Issued in PA
Legal business name
FAMILY PRACTICE OF JEFFERSONVILLE, LLC
Practice address
190 W Germantown Pike
Suite 155
East Norriton, PA 19401-1385
Phone
(610) 277-9040
Fax
(610) 277-7890
NPI assigned
Feb 23, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Authorized official

Name
Dr. Scott Yarmark, D.O.NPI 1265548648
Title
President
Phone
(610) 277-9040

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X OS006142L PA Primary

Addresses

Primary practice location

190 W Germantown Pike
Suite 155
East Norriton, PA 19401-1385

Mailing address

190 W Germantown Pike
Suite 155
East Norriton, PA 19401-1385
Phone (610) 277-9040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090310000619 PA Part B Supplier - Clinic/Group Practice 4789740184 Receives reassigned benefits from 8 practitioners
Practice locations: East Norriton, PA

National Provider Directory

National Provider Directory
Tax ID family
Family Practice of Jeffersonville2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

550 E Fornance St
Norristown, PA 19401
Phone (610) 272-5600

190 W Germantown Pike
Ste 155
Norristown, PA 19401
Phone (610) 229-9060

1246 W Main St
Norristown, PA 19401
Phone (610) 272-6111

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643068800000",
    "number": "1407096910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 W GERMANTOWN PIKE",
            "address_2": "SUITE 155",
            "city": "EAST NORRITON",
            "state": "PA",
            "postal_code": "194011385",
            "telephone_number": "610-277-9040",
            "fax_number": "610-277-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 W GERMANTOWN PIKE",
            "address_2": "SUITE 155",
            "city": "EAST NORRITON",
            "state": "PA",
            "postal_code": "194011385",
            "telephone_number": "610-277-9040",
            "fax_number": "610-277-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRACTICE OF JEFFERSONVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-23",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "YARMARK",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-277-9040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS006142L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Norriton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.