St. Luke'S Physician Group, Inc.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

ST. LUKE'S PHYSICIAN GROUP, INC.

Practice address

1200 Springhouse Rd
Allentown, PA 18104-2119

Phone

(610) 351-5700

NPI assigned

Jan 25, 2021

Organization subpart

Yes

Parent organization

ST. LUKE'S PHYSICIAN GROUP, INC.As reported in NPPES

Name

Sue Chiavaroli

Title

Cvo Enrollment Supervisor

Phone

(484) 526-3569

• St. Luke's Psychiatric Associates - Parkland ASD Springhouse Middle Sc Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 25, 2021.

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611532800000",
    "number": "1811587769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 S COMMERCE WAY",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180178891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SPRINGHOUSE RD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181042119",
            "telephone_number": "610-351-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S PHYSICIAN GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. LUKE'S PHYSICIAN GROUP, INC.",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-08",
        "status": "A",
        "authorized_official_last_name": "CHIAVAROLI",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "CVO ENROLLMENT SUPERVISOR",
        "authorized_official_telephone_number": "484-526-3569"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Luke's Psychiatric Associates - Parkland ASD Springhouse Middle Sc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• St. Luke'S Physician Group, Inc.
• St. Luke'S Physician Group, Inc.
• St. Luke'S Physician Group, Inc.
• St. Luke'S Physician Group, Inc.
• St. Luke'S Physician Group, Inc.
• St. Luke'S Physician Group, Inc.
• St. Luke'S Physician Group, Inc.
• St. Luke'S Physician Group, Inc.
• St. Luke'S Physician Group, Inc.
• St. Luke'S Physician Group, Inc.

• All providers in Allentown, PA
• Mental Health Clinic/Center (Including Community Mental Health Center) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.