Active NPI
Ciera Rae Damon, PA-C
- Physician Assistant
- Philadelphia, PA
National Provider Identifier
1730660895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MA059961
- Practice address
- 3401 N Broad St
Philadelphia, PA 19140-5103 - Phone
- (267) 273-8512
- NPI assigned
- Aug 27, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MA059961 | PA | Primary |
Addresses
Primary practice location
3401 N Broad St
Philadelphia, PA 19140-5103
Mailing address
3401 N Broad Street
Parkinson Pavilion 3Rd Floor - Cardiovascular Surgery
Philadelphia, PA 19140
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA059961 | PA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535328000000",
"number": "1730660895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3401 N BROAD STREET",
"address_2": "PARKINSON PAVILION 3RD FLOOR - CARDIOVASCULAR SURGERY",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 N BROAD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191405103",
"telephone_number": "267-273-8512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAMON",
"first_name": "CIERA",
"middle_name": "RAE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-27",
"last_updated": "2018-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA059961",
"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 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.