Active NPI
Beppu
- Family Nurse Practitioner
- Philadelphia, PA
National Provider Identifier
1487128674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Legal business name
- BEPPU
- Practice address
- 6378 Woodbine Ave
Philadelphia, PA 19151-2526 - Phone
- (215) 341-1327
- NPI assigned
- Jan 22, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jeanine Dunmore, CRNP
- Title
- Director
- Phone
- (215) 341-1327
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | Primary |
Addresses
Primary practice location
6378 Woodbine Ave
Philadelphia, PA 19151-2526
Mailing address
6378 Woodbine Ave
Philadelphia, PA 19151-2526
Phone (215) 341-1327
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Bala Cynwyd, PA
- NPI 1033550991
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548115200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1548115200000",
"number": "1487128674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6378 WOODBINE AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191512526",
"telephone_number": "215-341-1327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6378 WOODBINE AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191512526",
"telephone_number": "215-341-1327"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BEPPU",
"organizational_subpart": "NO",
"enumeration_date": "2019-01-22",
"last_updated": "2019-01-22",
"status": "A",
"authorized_official_last_name": "DUNMORE",
"authorized_official_first_name": "JEANINE",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "215-341-1327",
"authorized_official_credential": "CRNP"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"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 Jan 22, 2019; 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.