Active NPI
Rediclinic LLC
- Clinic/Center
- Philadelphia, PA
National Provider Identifier
1700904331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- REDICLINIC LLC
- Practice address
- 3200 Red Lion Rd # 92
Philadelphia, PA 19114-1129 - Phone
- (866) 935-0333
- Fax
- (713) 935-9353
- NPI assigned
- Mar 26, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Rick Van Pelt
- Title
- VP of Operations
- Phone
- (713) 935-0333
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Primary |
Addresses
Primary practice location
3200 Red Lion Rd # 92
Philadelphia, PA 19114-1129
Mailing address
18059 Crescent Royale Way
Humble, TX 77346-3467
Phone (713) 935-0333
National Provider Directory
National Provider Directory- Tax ID family
- Rediclinic LLC
Other organizations with this tax ID 17
Organizations that report the same tax identification number in the National Provider Directory.
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- NPI 1235257833
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- NPI 1548309164
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- Katy, TX
- NPI 1588782601
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1700904331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18059 CRESCENT ROYALE WAY",
"city": "HUMBLE",
"state": "TX",
"postal_code": "773463467",
"telephone_number": "713-935-0333",
"fax_number": "713-935-9353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 RED LION RD # 92",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191141129",
"telephone_number": "866-935-0333",
"fax_number": "713-935-9353"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "REDICLINIC LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-26",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "VAN PELT",
"authorized_official_first_name": "RICK",
"authorized_official_title_or_position": "VP OF OPERATIONS",
"authorized_official_telephone_number": "713-935-0333",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, 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.