Organization Active NPI

Vansant Medicine, Inc

  • Adult Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1538501192
Registry record updated Jul 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
OS010207L Issued in PA
Legal business name
VANSANT MEDICINE, INC
Practice address
901 E Passyunk Ave
Philadelphia, PA 19147-2924
Phone
(215) 551-0200
Fax
(215) 551-0209
NPI assigned
Jul 24, 2013
Last updated
Jul 24, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2013

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

Authorized official

Name
Dr. Monika Vansant, D.O.NPI 1962441683
Title
President
Phone
(215) 551-0200

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X DC006091L PA
Adult Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0505X OS010207L PA Primary
Primary Care Clinic/Center 261QP2300X OS010207L PA

Addresses

Primary practice location

901 E Passyunk Ave
Philadelphia, PA 19147-2924

Mailing address

901 E Passyunk Ave
Philadelphia, PA 19147-2924
Phone (215) 551-0200

Other identifiers 1

IdentifierTypeStateIssuer
18130700001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150928000026 PA Part B Supplier - Clinic/Group Practice 5395053243 Receives reassigned benefits from 6 practitioners
Practice locations: Philadelphia, PA

National Provider Directory

National Provider Directory

Locations

801 Washington Ave
#21C
Philadelphia, PA 19147

801 Washington Ave
Ste C
Philadelphia, PA 19147
Phone (215) 551-0200

801 Washington Ave
Unit C
Philadelphia, PA 19147
Phone (215) 551-0200

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374624000000",
    "number": "1538501192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E PASSYUNK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191472924",
            "telephone_number": "215-551-0200",
            "fax_number": "215-551-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 E PASSYUNK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191472924",
            "telephone_number": "215-551-0200",
            "fax_number": "215-551-0209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANSANT MEDICINE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-24",
        "last_updated": "2013-07-24",
        "status": "A",
        "authorized_official_last_name": "VANSANT",
        "authorized_official_first_name": "MONIKA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-551-0200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC006091L",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "PA",
            "license": "OS010207L",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "PA",
            "license": "OS010207L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18130700001",
            "state": "PA"
        }
    ],
    "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 Jul 24, 2013; 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.