Organization Active NPI

Mobile Wound Consultants

  • Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1477628485
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
MOBILE WOUND CONSULTANTS
Practice address
1900 S Broad St
Philadelphia, PA 19145-2304
Phone
(856) 845-0500
Fax
(856) 384-8757
NPI assigned
Nov 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Theresa Brady, CRNP
Title
Partner
Phone
(856) 845-0500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

1900 S Broad St
Philadelphia, PA 19145-2304

Mailing address

127 N Broad St
Woodbury, NJ 08096-1718
Phone (856) 845-0500

National Provider Directory

National Provider Directory

Locations

127 N Broad St
Woodbury, NJ 08096
Phone (856) 845-0500

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477628485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 N BROAD ST",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080961718",
            "telephone_number": "856-845-0500",
            "fax_number": "856-384-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191452304",
            "telephone_number": "856-845-0500",
            "fax_number": "856-384-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE WOUND CONSULTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRADY",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "856-845-0500",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "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 Aug 22, 2020; 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.