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Organization Active NPI

Tower Drexel Academic Medical Group LLC

Doing business as Gastroenterology Tower Health Medical Group Broad Street

  • Gastroenterology Physician
  • Philadelphia, PA
National Provider Identifier
1407492333
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
TOWER DREXEL ACADEMIC MEDICAL GROUP LLC
Doing business as
Gastroenterology Tower Health Medical Group Broad Street
Practice address
219 N Broad St FL 9
Philadelphia, PA 19107-1506
Phone
(610) 743-6049
NPI assigned
Nov 26, 2019
Last updated
Nov 26, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Authorized official

Name
Gary Conner
Title
VP Ceo
Phone
(484) 628-8181

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X Primary

Addresses

Primary practice location

219 N Broad St FL 9
Philadelphia, PA 19107-1506

Mailing address

PO Box 13579
Reading, PA 19612-3579

Other names 1

  • Gastroenterology Tower Health Medical Group Broad Street Doing business as

National Provider Directory

National Provider Directory
Tax ID family
County Intermediate Unit18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1574726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574726400000",
    "number": "1407492333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 N BROAD ST FL 9",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071506",
            "telephone_number": "610-743-6049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWER DREXEL ACADEMIC MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-26",
        "last_updated": "2019-11-26",
        "status": "A",
        "authorized_official_last_name": "CONNER",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "VP CEO",
        "authorized_official_telephone_number": "484-628-8181"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gastroenterology Tower Health Medical Group Broad Street",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 26, 2019; 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.