City Line Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0S005355L Issued in PA

Legal business name

CITY LINE PEDIATRICS

Practice address

4190 City Ave
Suite 540
Philadelphia, PA 19131-1626

Phone

(215) 871-1800

Fax

(215) 871-1807

NPI assigned

Jul 11, 2006

Last updated

Sep 4, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Kathleen Gibbons

Title

Biller

Phone

(215) 871-1800

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lee Ann Brodzik, D.O.

  • Pediatrics Physician
  • Philadelphia, PA
  • NPI 1053330621
  NPD (past)
• Carl R Pullen, D.O.

  • Pediatrics Physician
  • Philadelphia, PA
  • NPI 1811922420
  NPD (past)
• Rosemary Vickers, D.O.

  • Pediatrics Physician
  • Philadelphia, PA
  • NPI 1619996279
  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220486400000",
    "number": "1477588135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 CITY AVE",
            "address_2": "SUITE 540",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311626",
            "telephone_number": "215-871-1800",
            "fax_number": "215-871-1807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 CITY AVE",
            "address_2": "SUITE 540",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311626",
            "telephone_number": "215-871-1800",
            "fax_number": "215-871-1807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY LINE PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2008-09-04",
        "status": "A",
        "authorized_official_last_name": "GIBBONS",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "215-871-1800",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "0S005355L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Citrone
• City Chiropractic & Rehabilitation
• City Community Care
• City Dental LLC
• City Line E.N.T., PC
• City of Phila Trustee Acting by the BRD of Dir of City Trusts
• City of Philadelphia (Health Care Center 6)
• City of Philadelphia (Health Care Center 4)
• City of Philadelphia (City of Philadelphia - Fire Department)
• City of Philadelphia (Strawberry Mansion Health Center)

• Pediatrics Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.