NPIMap

Organization Active NPI

St Luke's Physician Group Inc

Doing business as St. Luke's Pediatric Specialists

  • Pediatric Gastroenterology Physician
  • Bethlehem, PA
National Provider Identifier
1699851709
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
Legal business name
ST LUKE'S PHYSICIAN GROUP INC
Doing business as
St. Luke's Pediatric Specialists
Practice address
153 Brodhead Rd
Bethlehem, PA 18017-8931
Phone
(610) 954-4975
Fax
(610) 954-6485
NPI assigned
Oct 31, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dean W Evans
Title
President
Phone
(610) 954-4991

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X PA Primary

Addresses

Primary practice location

153 Brodhead Rd
Bethlehem, PA 18017-8931

Mailing address

623 E Broad St
2ND FLR
Bethlehem, PA 18018-6332
Phone (610) 954-6048

Other names 1

  • ST. LUKE'S PEDIATRIC SPECIALISTS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Upper Bucks Emergency M165 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699851709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 E BROAD ST",
            "address_2": "2ND FLR",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180186332",
            "telephone_number": "610-954-6048",
            "fax_number": "610-954-3189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 BRODHEAD RD",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180178931",
            "telephone_number": "610-954-4975",
            "fax_number": "610-954-6485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKE'S PHYSICIAN GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-954-4991"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST. LUKE'S PEDIATRIC SPECIALISTS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bethlehem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.