Organization Active NPI

General Practice Inc

Doing business as St Vincent Medical Associates

  • General Practice Physician
  • Phila, PA
National Provider Identifier
1467514794
Registry record updated Jul 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
GENERAL PRACTICE INC
Doing business as
St Vincent Medical Associates
Practice address
703 Cecil B Moore Ave
Phila, PA 19122
Phone
(215) 763-9564
Fax
(215) 763-1165
NPI assigned
Dec 14, 2006
Last updated
Jul 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2010

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

Authorized official

Name
Myron Rodos, DO
Title
Physician
Phone
(215) 763-9564

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

703 Cecil B Moore Ave
Phila, PA 19122

Mailing address

703 Cecil B Moore Ave
Phila, PA 19122
Phone (215) 763-9564

Other identifiers 1

IdentifierTypeStateIssuer
041759GGJOtherPHYSICIAN MEDICARE

Other names 1

  • St Vincent Medical Associates Doing business as

National Provider Directory

National Provider Directory

Locations

703 Cecil B Moore Ave
Philadelphia, PA 19122
Phone (215) 725-4343

703 Cecil B Moore Ave
#A
Philadelphia, PA 19122
Phone (215) 763-9564

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277942400000",
    "number": "1467514794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 CECIL B MOORE AVE",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "19122",
            "telephone_number": "215-763-9564",
            "fax_number": "215-763-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 CECIL B MOORE AVE",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "19122",
            "telephone_number": "215-763-9564",
            "fax_number": "215-763-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERAL PRACTICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2010-07-01",
        "status": "A",
        "authorized_official_last_name": "RODOS",
        "authorized_official_first_name": "MYRON",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "215-763-9564",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN MEDICARE",
            "identifier": "041759GGJ",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Vincent Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phila, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; 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.