Erie Physicians Network- Upmc Inc

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

OS005969L Issued in PA

Legal business name

ERIE PHYSICIANS NETWORK- UPMC INC

Practice address

3535 Pine Ave
Ste 1
Erie, PA 16504-1743

Phone

(814) 454-3363

NPI assigned

Feb 6, 2012

Organization subpart

Yes

Parent organization

MEDVANTX, INC.As reported in NPPES

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

Authorized official

Name

Kenny Heine

Title

VP of Operations

Phone

(858) 964-1506

Specialties & licenses 1

Addresses

Other names 1

• Pinecrest Family Practice (Pine Avenue) Doing business as

Tax ID family

Erie Physician Network-Upmcinc2 organizations share this tax ID, including this one

Part of

Tri - State Medical Group Inc

Other organizations with this tax ID 1

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

• Erie Physician Network-Upmc,Inc

  • Neuromusculoskeletal Medicine & OMM Physician
  • Erie, PA
  • NPI 1821346933
  NPD tax ID

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

{
    "created_epoch": "1328486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369267200000",
    "number": "1629340609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 PINE AVE",
            "address_2": "STE 1",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165041743",
            "telephone_number": "814-454-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIE PHYSICIANS NETWORK- UPMC INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2012-02-06",
        "last_updated": "2013-05-23",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OF  OPERATIONS",
        "authorized_official_telephone_number": "858-964-1506"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "PA",
            "license": "OS005969L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pinecrest Family Practice (Pine Avenue)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erie Osteopathic Medicine, LLC
• Erie Pharmacy
• Erie Physician Network-Upmc,Inc
• Erie Physicians Network PC
• Erie Physicians Network PC
• Erie Physicians Network-Upmc,Inc
• Erie Physicians Network, PC
• Erie Physicians Network, PC
• Erie Physicians Network, PC
• Erie Psychiatric Associates, LLC

• Non-Pharmacy Dispensing Site in Erie, PA
• Providers in Erie, PA by specialty
• Non-Pharmacy Dispensing Site in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2013; 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.