Sewickley Valley Medical Group Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SEWICKLEY VALLEY MEDICAL GROUP INC

Practice address

701 Broad St
Ste B FLR 4
Sewickley, PA 15143-1652

Phone

(412) 741-0985

Fax

(412) 741-7539

NPI assigned

May 27, 2006

Last updated

Oct 30, 2007By 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

Mr. Norman F Mitry

Title

President and Ceo

Phone

(724) 773-4779

Specialties & licenses 7

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Susan Teresa Moran, PA-C

  • Physician Assistant
  • Sewickley, PA
  • NPI 1760497242
  NPD (past)

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193702400000",
    "number": "1689621583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PEARTREE WAY",
            "city": "BEAVER",
            "state": "PA",
            "postal_code": "150091954",
            "telephone_number": "724-728-4171",
            "fax_number": "724-728-2019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 BROAD ST",
            "address_2": "STE B FLR 4",
            "city": "SEWICKLEY",
            "state": "PA",
            "postal_code": "151431652",
            "telephone_number": "412-741-0985",
            "fax_number": "412-741-7539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEWICKLEY VALLEY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2007-10-30",
        "status": "A",
        "authorized_official_last_name": "MITRY",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "724-773-4779",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014950830029",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sewickley Pathologists
• Sewickley Physical Therapy LLC
• Sewickley Primary Care, LLC
• Sewickley Spine & Joint Center PC
• Sewickley Valley Hospital
• Sewickley Valley Pediatrics & Adolescent Medicine
• Ian Brooks Shadle, DPT, ATC, CSCS
• Rachel Shaheen, PTA
• Emily N Sharp, PA-C
• Sydney Shaughnessy

• Family Medicine Physician in Sewickley, PA
• Providers in Sewickley, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; 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.