Active NPI
Jennifer Deardorff
- Medical Physician Assistant
- West Chester, PA
National Provider Identifier
1811348758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- MA058221
- Practice address
- 701 E Marshall St
West Chester, PA 19380-4412 - Phone
- (610) 431-5000
- NPI assigned
- Jun 22, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | MA058221 | PA | |
| Medical Physician Assistant | 363AM0700X | MA058221 | PA | Primary |
Addresses
Primary practice location
701 E Marshall St
West Chester, PA 19380-4412
Mailing address
140 Wright St
Philadelphia, PA 19127-1922
Phone (717) 817-0024
Other practice location 1
5501 Old York Rd
Philadelphia, PA 19141-3018
Phone (800) 346-7834
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA058221 | PA | MD | Student in an Organized Health Care Education/Training Program |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emergency Medicine Physician
- West Chester, PA
- NPI 1023044278
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1811348758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 WRIGHT ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191271922",
"telephone_number": "717-817-0024",
"fax_number": "215-258-1037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 E MARSHALL ST",
"city": "WEST CHESTER",
"state": "PA",
"postal_code": "193804412",
"telephone_number": "610-431-5000"
}
],
"practiceLocations": [
{
"address_1": "5501 Old York Rd",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191413018",
"country_code": "US",
"telephone_number": "800-346-7834",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DEARDORFF",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-22",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "PA",
"license": "MA058221",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PA",
"license": "MA058221",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Chester, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.