NPIMap

Organization Active NPI

Easter Seals of Southeastern Pennsylvania

  • Registered Nurse
  • Philadelphia, PA
National Provider Identifier
1740317916
Registry record updated Mar 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
Legal business name
EASTER SEALS OF SOUTHEASTERN PENNSYLVANIA
Practice address
3975 Conshohocken Ave
Philadelphia, PA 19131-5426
Phone
(215) 879-1000
Fax
(215) 879-8424
NPI assigned
Feb 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2015

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

Authorized official

Name
Ms. Ivy C Lewis
Title
Dir of Finance Cfo
Phone
(215) 879-3542

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X Primary

Addresses

Primary practice location

3975 Conshohocken Ave
Philadelphia, PA 19131-5426

Mailing address

3975 Conshohocken Ave
Philadelphia, PA 19131-5426
Phone (215) 879-1000

Other identifiers 1

IdentifierTypeStateIssuer
1000005500021MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Easter Seals of Southeastern Pennsylvania5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3975 Conshohocken Ave
Philadelphia, PA 19131
Phone (215) 879-1000

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427155200000",
    "number": "1740317916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3975 CONSHOHOCKEN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191315426",
            "telephone_number": "215-879-1000",
            "fax_number": "215-879-8424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 CONSHOHOCKEN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191315426",
            "telephone_number": "215-879-1000",
            "fax_number": "215-879-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTER SEALS OF SOUTHEASTERN PENNSYLVANIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2015-03-24",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "IVY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIR OF FINANCE CFO",
        "authorized_official_telephone_number": "215-879-3542",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000005500021",
            "state": "PA"
        }
    ],
    "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 Mar 24, 2015; 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.