NPIMap

Organization Active NPI

Tower Drexel Academic Medical Group LLC

  • Nephrology Physician
  • Philadelphia, PA
National Provider Identifier
1497398192
Registry record updated Oct 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
TOWER DREXEL ACADEMIC MEDICAL GROUP LLC
Practice address
219 N Broad St FL 9
Philadelphia, PA 19107-1506
Phone
(610) 743-6049
NPI assigned
Oct 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2019

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

Authorized official

Name
Gary Conner
Title
Ceo
Phone
(484) 628-8181

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

219 N Broad St FL 9
Philadelphia, PA 19107-1506

Mailing address

PO Box 13579
Reading, PA 19612-3579
Phone (610) 743-6049

Other names 1

  • Nephrology Tower Health Medical Group Broad Street Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address PROVIDERENROLLMENT@TOWERHEALTH.ORG Direct

National Provider Directory

National Provider Directory
Tax ID family
County Intermediate Unit18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1571961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571961600000",
    "number": "1497398192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579",
            "telephone_number": "610-743-6049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 N BROAD ST FL 9",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071506",
            "telephone_number": "610-743-6049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWER DREXEL ACADEMIC MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-25",
        "last_updated": "2019-10-25",
        "status": "A",
        "authorized_official_last_name": "CONNER",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "484-628-8181"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "PROVIDERENROLLMENT@TOWERHEALTH.ORG",
            "affiliation": "N",
            "endpointDescription": "PROVIDERENROLLMENT@TOWERHEALTH.ORG",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EMAIL",
            "address_1": "219 N Broad St Fl 9",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191071506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Nephrology Tower Health Medical Group Broad Street",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 25, 2019; 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.