Individual provider Active NPI

Mary London, FNP

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1699245498
Registry record updated Dec 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP019604 Issued in PA
Practice address
2534 S 18TH St
Philadelphia, PA 19145-3701
Phone
(215) 463-4363
NPI assigned
Dec 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN695130 PA
Family Nurse Practitioner 363LF0000X SP019604 PA Primary

Addresses

Primary practice location

2534 S 18TH St
Philadelphia, PA 19145-3701

Mailing address

2534 S 18TH St
Philadelphia, PA 19145-3701
Phone (215) 463-4363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190313000036 PA Practitioner - Nurse Practitioner 1759621691 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

111 S 11TH St
Philadelphia, PA 19107-4824
Phone (215) 955-6540

Hospital & facility affiliations

  • Jefferson Health at Home by Bayada Home health agency, Philadelphia, PA, CCN 397643
  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174
  • Magee Rehabilitation Hospital Inpatient rehabilitation facility, Philadelphia, PA, CCN 393038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN695130PAMDRegistered Nurse
SP019604PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Associates in Healthcare, Inc CurrentSince Mar 30, 2021 Accepting new patients
Methodist Associates in Healthcare, Inc CurrentSince Mar 30, 2021 Accepting new patients
Jefferson University Physicians CurrentSince Jan 8, 2019 Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

1818 E Passyunk Ave
Philadelphia, PA 19148
Phone (215) 468-2553

111 S 11th St
Ste 6270
Philadelphia, PA 19107
Phone (215) 955-6540

3 Crescent Dr
Fl 2
Philadelphia, PA 19112
Phone (215) 503-7096

2301 S Broad St
Ste 102
Philadelphia, PA 19148
Phone (215) 952-5175

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1543968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1699245498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2534 S 18TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191453701",
            "telephone_number": "215-463-4363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2534 S 18TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191453701",
            "telephone_number": "215-463-4363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONDON",
        "first_name": "MARY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-05",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN695130",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP019604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.