NPIMap

Organization Active NPI

Pre Diabetes Physician Services Inc

  • Specialist
  • King of Prussia, PA
National Provider Identifier
1568873941
Registry record updated May 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD036645L Issued in GA
Legal business name
PRE DIABETES PHYSICIAN SERVICES INC
Practice address
491 Allendale Rd Ste 222
King of Prussia, PA 19406-1431
Phone
(512) 623-4900
NPI assigned
May 19, 2014
Last updated
May 19, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2014

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

Authorized official

Name
Randy Marfin
Title
Ceo
Phone
(512) 623-4928

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD036645L GA Primary

Addresses

Primary practice location

491 Allendale Rd Ste 222
King of Prussia, PA 19406-1431

Mailing address

3721 Executive Center Dr Ste 160
Austin, TX 78731-1607
Phone (512) 623-4900

National Provider Directory

National Provider Directory
Tax ID family
Pre Diabetes Physician Services Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400457600000",
    "number": "1568873941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3721 EXECUTIVE CENTER DR STE 160",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787311607",
            "telephone_number": "512-623-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "491 ALLENDALE RD STE 222",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194061431",
            "telephone_number": "512-623-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRE DIABETES PHYSICIAN SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-19",
        "last_updated": "2014-05-19",
        "status": "A",
        "authorized_official_last_name": "MARFIN",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "512-623-4928"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "MD036645L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in King of Prussia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2014; 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.