Organization Active NPI

Beppu

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1487128674
Registry record updated Jan 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
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

Updated by the provider on Jan 22, 2019

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

Authorized official

Name
Jeanine Dunmore, CRNPNPI 1033550991
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)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 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

Enrollment IDStateProvider typePAC IDDetails
O20210113000360 PA Part B Supplier - Clinic/Group Practice 5092128009 Receives reassigned benefits from 1 practitioner
Practice locations: Philadelphia, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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.

Verify at the official NPI Registry.