NPIMap

Organization Active NPI

Fornance Physician Services, Inc.

Doing business as King of Prussia Family Medicine

  • Family Medicine Physician
  • King of Prussia, PA
National Provider Identifier
1831146919
Registry record updated Nov 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FORNANCE PHYSICIAN SERVICES, INC.
Doing business as
King of Prussia Family Medicine
Practice address
210 Mall Blvd Ste 102
King of Prussia, PA 19406-3260
Phone
(610) 265-0726
Fax
(610) 265-3132
NPI assigned
May 27, 2006
Last updated
Nov 10, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2018

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

Authorized official

Name
Suzanne Rice
Title
Credentialing Specialist
Phone
(484) 622-7371

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

210 Mall Blvd Ste 102
King of Prussia, PA 19406-3260

Mailing address

PO Box 789967
Philadelphia, PA 19178-9967
Phone (484) 622-7395

Other identifiers 10

IdentifierTypeStateIssuer
1738323MedicaidPA
CI4349OtherPARRM
0418121001OtherPAAMERIHEALTH/INTERCOUNTY
26575OtherPAHEALTH PARTNERS SITE #
639587OtherPAHIGHMARK BLUE SHIELD
0418121001OtherPAIBC - PC/KHPE
5242713OtherPAAETNA PPO
1112971OtherPAKEYSTONE MERCY
2047128OtherPAAETNA HMO
6522623OtherPACIGNA HMO/PPO

Other names 1

  • King of Prussia Family Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040216000037 PA Part B Supplier - Clinic/Group Practice 8527962661 Receives reassigned benefits from 215 practitioners
36 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: King of Prussia, PA; Lansdale, PA; Norristown, PA; North Wales, PA; Plymouth Meeting, PA; East Norriton, PA; Audubon, PA; Blue Bell, PA…

Other NPIs on the same Medicare enrollment 36

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 36

National Provider Directory

National Provider Directory
Tax ID family
Fornance Physician Services Inc28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541808000000",
    "number": "1831146919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 789967",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191789967",
            "telephone_number": "484-622-7395",
            "fax_number": "484-622-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 MALL BLVD STE 102",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063260",
            "telephone_number": "610-265-0726",
            "fax_number": "610-265-3132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORNANCE PHYSICIAN SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2018-11-10",
        "status": "A",
        "authorized_official_last_name": "RICE",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "484-622-7371"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1738323",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRM",
            "identifier": "CI4349",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH/INTERCOUNTY",
            "identifier": "0418121001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS SITE #",
            "identifier": "26575",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "639587",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC - PC/KHPE",
            "identifier": "0418121001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "5242713",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "1112971",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2047128",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HMO/PPO",
            "identifier": "6522623",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "King of Prussia Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "King of Prussia Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in King of Prussia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.