Patricia Wallace Belancio, CRNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

SP011629 Issued in PA

Practice address

1722 Bethlehem Pike
Flourtown, PA 19031-1644

Phone

(215) 233-9700

Fax

(215) 233-9710

NPI assigned

Jun 8, 2012

Last updated

Jun 8, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Patricia Dolores Wallace Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Temple Physicians Inc

  • Obstetrics & Gynecology Physician
  • Philadelphia, PA
  • NPI 1033471982
  NPD (past)

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

{
    "created_epoch": "1339113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339113600000",
    "number": "1700148459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 820933",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191820933",
            "telephone_number": "215-926-9010",
            "fax_number": "215-226-8285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 BETHLEHEM PIKE",
            "city": "FLOURTOWN",
            "state": "PA",
            "postal_code": "190311644",
            "telephone_number": "215-233-9700",
            "fax_number": "215-233-9710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELANCIO",
        "first_name": "PATRICIA",
        "middle_name": "WALLACE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-08",
        "last_updated": "2012-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP011629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "WALLACE",
            "middle_name": "DOLORES",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marie Bailey, MD
• Laura A Baker, M.ED
• Laurie B. Baker, M.S.W., L.C.S.W.
• Bariatric Medicine Institute
• Madison Bear, LSW
• Nancy Belser, MD
• Laura C Beringer, CRNP
• Charles H Blonstein, PHD
• Raphael T Bloomgarden, M.D.
• Bonavitacola Psychological Services, LLC (BonaVita Psychology)

• Adult Health Nurse Practitioner in Flourtown, PA
• Providers in Flourtown, PA by specialty
• Adult Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2012; 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.