Suburban Gastroenterology Associates Inc

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

SUBURBAN GASTROENTEROLOGY ASSOCIATES INC

Practice address

1010 West Chester Pike
Ste 202
Havertown, PA 19083-3442

Phone

(610) 789-3510

Fax

(610) 789-3591

NPI assigned

Jul 13, 2006

Last updated

May 15, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark Jacobs, MDNPI 1013943885

Title

President

Phone

(610) 789-3510

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 3

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.

• Mark Jacobs, MD

  • Gastroenterology Physician
  • Havertown, PA
  • NPI 1013943885
  Authorized official Same address or phone
• Sarah R Liskey, PA-C

  • Physician Assistant
  • Lititz, PA
  • NPI 1427246446
  NPD (past)
• Michael J Brooks, MD

  • Specialist
  • Wilmington, DE
  • NPI 1881695039
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1548285141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 WEST CHESTER PIKE",
            "address_2": "STE 202",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190833442",
            "telephone_number": "610-789-3510",
            "fax_number": "610-789-3591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 WEST CHESTER PIKE",
            "address_2": "STE 202",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190833442",
            "telephone_number": "610-789-3510",
            "fax_number": "610-789-3591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN GASTROENTEROLOGY ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-789-3510",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CF6518",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078329002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeannine Leigh Stokes, OT
• Rosa Stokes
• Robin M Stott-McNulty, M.P.T.
• Grant Nelson Strine, PSY.D.
• Diana Lyn Stroffolino, MPT
• Suburban Oral Surgery, PC
• Heather M Sullivan, CRNA
• Kenisha Sullivan, LPC
• Sunrise Human Care Services Inc
• Sunshine Therapy Club II

• Gastroenterology Physician in Havertown, PA
• Providers in Havertown, PA by specialty
• Gastroenterology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.