Organization Active NPI

Larchwood Medical Associates

  • Internal Medicine Physician
  • Phila, PA
National Provider Identifier
1558387951
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD019877E Issued in PA
Legal business name
LARCHWOOD MEDICAL ASSOCIATES
Practice address
501 S 54TH St
Ste 227
Phila, PA 19143-1900
Phone
(215) 528-5288
Fax
(215) 528-5033
NPI assigned
Jul 15, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Raymond Lloyd Coleman, MDNPI 1487781639
Title
President
Phone
(215) 528-5288

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD019877E PA Primary

Addresses

Primary practice location

501 S 54TH St
Ste 227
Phila, PA 19143-1900

Mailing address

501 S 54TH St
Ste 227
Phila, PA 19143-1900
Phone (215) 528-5288

Other identifiers 3

IdentifierTypeStateIssuer
0674187001OtherPAKEYSTONE
0688521MedicaidPA
0054772000OtherPABLUE CROSS BLUE SHIELD

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, 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": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558387951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S 54TH ST",
            "address_2": "STE 227",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191431900",
            "telephone_number": "215-528-5288",
            "fax_number": "215-528-5033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S 54TH ST",
            "address_2": "STE 227",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191431900",
            "telephone_number": "215-528-5288",
            "fax_number": "215-528-5033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARCHWOOD MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "LLOYD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-528-5288",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD019877E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE",
            "identifier": "0674187001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0688521",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0054772000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phila, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.