NPIMap

Organization Active NPI

Memphis Street Academy Charter School

  • Pediatric Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1588040117
Registry record updated Aug 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
Legal business name
MEMPHIS STREET ACADEMY CHARTER SCHOOL
Practice address
2950 Memphis St
Philadelphia, PA 19134-4314
Phone
(215) 291-4709
Fax
(215) 291-4754
NPI assigned
Aug 5, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2015

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

Authorized official

Name
Julie Emig
Title
Executive Director
Phone
(215) 687-6286

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0200X Primary

Addresses

Primary practice location

2950 Memphis St
Philadelphia, PA 19134-4314

Mailing address

970 Sproul Rd
Bryn Mawr, PA 19010-2026

National Provider Directory

National Provider Directory
Tax ID family
La Salle Academy18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1438732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438732800000",
    "number": "1588040117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 SPROUL RD",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190102026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 MEMPHIS ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191344314",
            "telephone_number": "215-291-4709",
            "fax_number": "215-291-4754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMPHIS STREET ACADEMY CHARTER SCHOOL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-05",
        "last_updated": "2015-08-05",
        "status": "A",
        "authorized_official_last_name": "EMIG",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "215-687-6286"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 5, 2015; 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.