NPIMap

Organization Active NPI

Bethel Park Medical and Wellness

  • Sports Medicine (Family Medicine) Physician
  • Bethel Park, PA
National Provider Identifier
1619399805
Registry record updated Jan 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
MD420553 Issued in PA
Legal business name
BETHEL PARK MEDICAL AND WELLNESS
Practice address
2746 S Park Rd
Bethel Park, PA 15102-3806
Phone
(412) 831-8000
Fax
(412) 833-2536
NPI assigned
Jan 8, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2014

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

Authorized official

Name
Debra Leonard
Title
Credentialing Manager
Phone
(412) 279-4522

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QS0010X MD420553 PA Primary

Addresses

Primary practice location

2746 S Park Rd
Bethel Park, PA 15102-3806

Mailing address

2746 S Park Rd
Bethel Park, PA 15102-3806
Phone (412) 831-8000

National Provider Directory

National Provider Directory

Locations

2746 S Park Rd
Bethel Park, PA 15102
Phone (412) 831-8000

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1389139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389139200000",
    "number": "1619399805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2746 S PARK RD",
            "city": "BETHEL PARK",
            "state": "PA",
            "postal_code": "151023806",
            "telephone_number": "412-831-8000",
            "fax_number": "412-833-2536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2746 S PARK RD",
            "city": "BETHEL PARK",
            "state": "PA",
            "postal_code": "151023806",
            "telephone_number": "412-831-8000",
            "fax_number": "412-833-2536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHEL PARK MEDICAL AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-08",
        "last_updated": "2014-01-08",
        "status": "A",
        "authorized_official_last_name": "LEONARD",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "412-279-4522"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": "PA",
            "license": "MD420553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethel Park, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.