Individual provider Active NPI

Angela M McGovern, MD

  • Neonatal-Perinatal Medicine Physician
  • Bryn Mawr, PA
National Provider Identifier
1497874630
Registry record updated Sep 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
MD424485 Issued in PA
Practice address
Bryn Mawr Hospital
130 S. Bryn Mawr Ave.
Bryn Mawr, PA 19010-3121
Phone
(610) 526-3000
NPI assigned
Mar 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD424485 PA
Neonatal-Perinatal Medicine Physician 2080N0001X MD424485 PA Primary

Addresses

Primary practice location

Bryn Mawr Hospital
130 S. Bryn Mawr Ave.
Bryn Mawr, PA 19010-3121

Mailing address

PO Box 191
Provider Enrollment Dept
Rockland, DE 19732-0191
Phone (302) 651-6212

Other identifiers 3

IdentifierTypeStateIssuer
101849316MedicaidPA
212052MedicaidMD
127621MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD424485PAMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316822400000",
    "number": "1497874630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "address_2": "PROVIDER ENROLLMENT DEPT",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "telephone_number": "302-651-6212",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BRYN MAWR HOSPITAL",
            "address_2": "130 S. BRYN MAWR AVE.",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103121",
            "telephone_number": "610-526-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOVERN",
        "first_name": "ANGELA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2011-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD424485",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "PA",
            "license": "MD424485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101849316",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212052",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127621",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2011; 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.