Philly As, LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

PHILLY AS, LLC

Practice address

1500 JFK Blvd
Ste 301
Philadelphia, PA 19102-1710

Phone

(610) 337-7662

NPI assigned

Apr 15, 2015

Last updated

Apr 15, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kevin Campbell

Title

Owner

Phone

(215) 205-8221

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429056000000",
    "number": "1669868725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 FIRST AVE",
            "address_2": "STE 100",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194061333",
            "telephone_number": "610-337-7662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 JFK BLVD",
            "address_2": "STE 301",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021710",
            "telephone_number": "610-337-7662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLY AS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-15",
        "last_updated": "2015-04-15",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-205-8221"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara J Phillips
• Sarah Phillips
• Sheneiah Phillips
• Tara Mulvey Phillips, CRNP
• Philly ABA Therapy LLC
• Philly Dietitian LLC
• Philly Drugstore LLC
• Philly Family Life Counseling, LLC
• Philly Ifs Therapy, LLC
• Philly Injury Center, Inc.

• Medical Specialty Clinic/Center in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Medical Specialty Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.